Neosuture formation after endoscope-assisted craniosynostosis repair

Afshin Salehi, Katherine Ott, Gary B. Skolnick, Dennis C. Nguyen, Sybill D. Naidoo, Alex A. Kane, Albert S. Woo, Kamlesh B. Patel, Matthew D. Smyth

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: The goal of this study was to identify the rate of neosuture formation in patients with craniosynostosis treated with endoscope-assisted strip craniectomy and investigate whether neosuture formation in sagittal craniosynostosis has an effect on postoperative calvarial shape. METHODS: The authors retrospectively reviewed 166 cases of nonsyndromic craniosynostosis that underwent endoscope-assisted repair between 2006 and 2014. Preoperative and 1-year postoperative head CT scans were evaluated, and the rate of neosuture formation was calculated. Three-dimensional reconstructions of the CT data were used to measure cephalic index (CI) (ratio of head width and length) of patients with sagittal synostosis. Regression analysis was used to calculate significant differences between patients with and without neosuture accounting for age at surgery and preoperative CI. RESULTS: Review of 96 patients revealed that some degree of neosuture development occurred in 23 patients (23.9%): 16 sagittal, 2 bilateral coronal, 4 unilateral coronal, and 1 lambdoid synostosis. Complete neosuture formation was seen in 14 of those 23 patients (9 of 16 sagittal, 1 of 2 bilateral coronal, 3 of 4 unilateral coronal, and 1 of 1 lambdoid). Mean pre- and postoperative CI in the complete sagittal neosuture group was 67.4% and 75.5%, respectively, and in the non-neosuture group was 69.8% and 74.4%, respectively. There was no statistically significant difference in the CI between the neosuture and fused suture groups preoperatively or 17 months postoperatively in patients with sagittal synostosis. CONCLUSIONS: Neosuture development can occur after endoscope-assisted strip craniectomy and molding helmet therapy for patients with craniosynostosis. Although the authors did not detect a significant difference in calvarial shape postoperatively in the group with sagittal synostosis, the relevance of neosuture formation remains to be determined. Further studies are required to discover long-term outcomes comparing patients with and without neosuture formation.

Original languageEnglish (US)
Pages (from-to)196-200
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Volume18
Issue number2
DOIs
StatePublished - Aug 1 2016

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Craniosynostoses
Endoscopes
Head
Head Protective Devices
Sutures
Regression Analysis

Keywords

  • Craniofacial
  • Endoscopy
  • Neosuture
  • Sagittal craniosynostosis
  • Scaphocephaly
  • Strip craniectomy
  • Suture re-formation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Salehi, A., Ott, K., Skolnick, G. B., Nguyen, D. C., Naidoo, S. D., Kane, A. A., ... Smyth, M. D. (2016). Neosuture formation after endoscope-assisted craniosynostosis repair. Journal of Neurosurgery: Pediatrics, 18(2), 196-200. https://doi.org/10.3171/2016.2.PEDS15231

Neosuture formation after endoscope-assisted craniosynostosis repair. / Salehi, Afshin; Ott, Katherine; Skolnick, Gary B.; Nguyen, Dennis C.; Naidoo, Sybill D.; Kane, Alex A.; Woo, Albert S.; Patel, Kamlesh B.; Smyth, Matthew D.

In: Journal of Neurosurgery: Pediatrics, Vol. 18, No. 2, 01.08.2016, p. 196-200.

Research output: Contribution to journalArticle

Salehi, A, Ott, K, Skolnick, GB, Nguyen, DC, Naidoo, SD, Kane, AA, Woo, AS, Patel, KB & Smyth, MD 2016, 'Neosuture formation after endoscope-assisted craniosynostosis repair', Journal of Neurosurgery: Pediatrics, vol. 18, no. 2, pp. 196-200. https://doi.org/10.3171/2016.2.PEDS15231
Salehi, Afshin ; Ott, Katherine ; Skolnick, Gary B. ; Nguyen, Dennis C. ; Naidoo, Sybill D. ; Kane, Alex A. ; Woo, Albert S. ; Patel, Kamlesh B. ; Smyth, Matthew D. / Neosuture formation after endoscope-assisted craniosynostosis repair. In: Journal of Neurosurgery: Pediatrics. 2016 ; Vol. 18, No. 2. pp. 196-200.
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abstract = "OBJECTIVE: The goal of this study was to identify the rate of neosuture formation in patients with craniosynostosis treated with endoscope-assisted strip craniectomy and investigate whether neosuture formation in sagittal craniosynostosis has an effect on postoperative calvarial shape. METHODS: The authors retrospectively reviewed 166 cases of nonsyndromic craniosynostosis that underwent endoscope-assisted repair between 2006 and 2014. Preoperative and 1-year postoperative head CT scans were evaluated, and the rate of neosuture formation was calculated. Three-dimensional reconstructions of the CT data were used to measure cephalic index (CI) (ratio of head width and length) of patients with sagittal synostosis. Regression analysis was used to calculate significant differences between patients with and without neosuture accounting for age at surgery and preoperative CI. RESULTS: Review of 96 patients revealed that some degree of neosuture development occurred in 23 patients (23.9{\%}): 16 sagittal, 2 bilateral coronal, 4 unilateral coronal, and 1 lambdoid synostosis. Complete neosuture formation was seen in 14 of those 23 patients (9 of 16 sagittal, 1 of 2 bilateral coronal, 3 of 4 unilateral coronal, and 1 of 1 lambdoid). Mean pre- and postoperative CI in the complete sagittal neosuture group was 67.4{\%} and 75.5{\%}, respectively, and in the non-neosuture group was 69.8{\%} and 74.4{\%}, respectively. There was no statistically significant difference in the CI between the neosuture and fused suture groups preoperatively or 17 months postoperatively in patients with sagittal synostosis. CONCLUSIONS: Neosuture development can occur after endoscope-assisted strip craniectomy and molding helmet therapy for patients with craniosynostosis. Although the authors did not detect a significant difference in calvarial shape postoperatively in the group with sagittal synostosis, the relevance of neosuture formation remains to be determined. Further studies are required to discover long-term outcomes comparing patients with and without neosuture formation.",
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AU - Skolnick, Gary B.

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AU - Naidoo, Sybill D.

AU - Kane, Alex A.

AU - Woo, Albert S.

AU - Patel, Kamlesh B.

AU - Smyth, Matthew D.

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N2 - OBJECTIVE: The goal of this study was to identify the rate of neosuture formation in patients with craniosynostosis treated with endoscope-assisted strip craniectomy and investigate whether neosuture formation in sagittal craniosynostosis has an effect on postoperative calvarial shape. METHODS: The authors retrospectively reviewed 166 cases of nonsyndromic craniosynostosis that underwent endoscope-assisted repair between 2006 and 2014. Preoperative and 1-year postoperative head CT scans were evaluated, and the rate of neosuture formation was calculated. Three-dimensional reconstructions of the CT data were used to measure cephalic index (CI) (ratio of head width and length) of patients with sagittal synostosis. Regression analysis was used to calculate significant differences between patients with and without neosuture accounting for age at surgery and preoperative CI. RESULTS: Review of 96 patients revealed that some degree of neosuture development occurred in 23 patients (23.9%): 16 sagittal, 2 bilateral coronal, 4 unilateral coronal, and 1 lambdoid synostosis. Complete neosuture formation was seen in 14 of those 23 patients (9 of 16 sagittal, 1 of 2 bilateral coronal, 3 of 4 unilateral coronal, and 1 of 1 lambdoid). Mean pre- and postoperative CI in the complete sagittal neosuture group was 67.4% and 75.5%, respectively, and in the non-neosuture group was 69.8% and 74.4%, respectively. There was no statistically significant difference in the CI between the neosuture and fused suture groups preoperatively or 17 months postoperatively in patients with sagittal synostosis. CONCLUSIONS: Neosuture development can occur after endoscope-assisted strip craniectomy and molding helmet therapy for patients with craniosynostosis. Although the authors did not detect a significant difference in calvarial shape postoperatively in the group with sagittal synostosis, the relevance of neosuture formation remains to be determined. Further studies are required to discover long-term outcomes comparing patients with and without neosuture formation.

AB - OBJECTIVE: The goal of this study was to identify the rate of neosuture formation in patients with craniosynostosis treated with endoscope-assisted strip craniectomy and investigate whether neosuture formation in sagittal craniosynostosis has an effect on postoperative calvarial shape. METHODS: The authors retrospectively reviewed 166 cases of nonsyndromic craniosynostosis that underwent endoscope-assisted repair between 2006 and 2014. Preoperative and 1-year postoperative head CT scans were evaluated, and the rate of neosuture formation was calculated. Three-dimensional reconstructions of the CT data were used to measure cephalic index (CI) (ratio of head width and length) of patients with sagittal synostosis. Regression analysis was used to calculate significant differences between patients with and without neosuture accounting for age at surgery and preoperative CI. RESULTS: Review of 96 patients revealed that some degree of neosuture development occurred in 23 patients (23.9%): 16 sagittal, 2 bilateral coronal, 4 unilateral coronal, and 1 lambdoid synostosis. Complete neosuture formation was seen in 14 of those 23 patients (9 of 16 sagittal, 1 of 2 bilateral coronal, 3 of 4 unilateral coronal, and 1 of 1 lambdoid). Mean pre- and postoperative CI in the complete sagittal neosuture group was 67.4% and 75.5%, respectively, and in the non-neosuture group was 69.8% and 74.4%, respectively. There was no statistically significant difference in the CI between the neosuture and fused suture groups preoperatively or 17 months postoperatively in patients with sagittal synostosis. CONCLUSIONS: Neosuture development can occur after endoscope-assisted strip craniectomy and molding helmet therapy for patients with craniosynostosis. Although the authors did not detect a significant difference in calvarial shape postoperatively in the group with sagittal synostosis, the relevance of neosuture formation remains to be determined. Further studies are required to discover long-term outcomes comparing patients with and without neosuture formation.

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KW - Endoscopy

KW - Neosuture

KW - Sagittal craniosynostosis

KW - Scaphocephaly

KW - Strip craniectomy

KW - Suture re-formation

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