Endoscopy-Assisted Craniosynostosis Surgery Versus Cranial Vault Remodeling for Non-Syndromic Craniosynostosis: Experience of a Single Center.

IF 0.9 4区医学 Q4 CLINICAL NEUROLOGY Turkish neurosurgery Pub Date : 2024-01-01 DOI:10.5137/1019-5149.JTN.43011-22.2

Baris Albuz, Mehmet Erdal Coskun, Emrah Egemen

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Abstract

Aim: To evaluate and compare open cranial vault remodeling (OCVR) and endoscopy-assisted craniosynostosis surgery (EACS) in patients with non-syndromic craniosynostosis and to develop an algorithm to determine the most appropriate surgery for each patient.

Material and methods: Eighty-five children with craniosynostosis who underwent surgery between 2010 and 2022 were retrospectively analyzed. Demographic data, comorbidities, and peri-operative findings of the patients were recorded. Pre- and post-operative comparisons were made between predetermined measurement techniques for each deformation. In addition, measurements were obtained by computed tomography (CT) or 3D stereophotogrammetric (3DSPG) methods from eligible patients and compared with one another.

Results: In our study, 61 patients underwent EACS, whereas 24 underwent OCVR. The operating time of OCVR was approximately 54.4 minutes longer than that of EACS (p < 0.001). The intra-operative blood loss was around 139 ml higher in OCVR (p < 0.001). The length of hospital stay for patients who underwent EACS was shorter at 8.4 days on average (p < 0.001). Surprisingly, 5 complications were observed in OCVR compared with 7 in EACS. While the cosmetic outcome of EACS was superior in most of the pathologyspecific measurement techniques, the metopic index increased only in patients with metopic synostosis after both surgical operations. Still, this increase was lower in EACS than in OCVR.

Conclusion: This study suggests that endoscopic craniosynostosis surgery has lower estimated blood loss and operation and hospitalization times, as well as comparable cosmetic results compared with open vault surgeries on long-term follow-up. CT and 3DSPG methods can help distinguish between different types of measurement techniques for synostoses. However, no significant differences were found in the comparisons since 3DSPG can also provide reliable measurements comparable to those on CT during follow-up.

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内窥镜辅助颅畸形手术与颅顶重塑术治疗非侏儒症颅畸形：单个中心的经验。

目的：评估并比较开放性颅顶重塑术（OCVR）和内窥镜辅助颅骨综合症手术（EACS）对非畸形颅骨综合症患者的治疗效果，并制定一种算法来确定最适合每位患者的手术方式：对2010年至2022年期间接受手术的85名颅突症儿童进行了回顾性分析。记录了患者的人口统计学数据、合并症和围手术期的检查结果。对每种变形的预定测量技术进行术前和术后比较。此外，还通过计算机断层扫描（CT）或三维立体摄影测量（3DSPG）方法对符合条件的患者进行了测量，并进行了比较：在我们的研究中，61 名患者接受了 EACS，24 名患者接受了 OCVR。OCVR 的手术时间比 EACS 长约 54.4 分钟（P < 0.001）。OCVR 的术中失血量比 EACS 高约 139 毫升（P < 0.001）。接受 EACS 的患者住院时间较短，平均为 8.4 天（p < 0.001）。令人惊讶的是，OCVR 观察到 5 例并发症，而 EACS 观察到 7 例。虽然在大多数病理特异性测量技术中，EACS 的美容效果更佳，但在两种手术操作后，仅有偏侧突眼患者的偏侧突眼指数有所增加。结论：本研究表明，内窥镜颅骨突触手术的估计失血量、手术时间和住院时间均低于开放式穹隆手术，而且在长期随访中，其美容效果与开放式穹隆手术相当。CT 和 3DSPG 方法有助于区分不同类型的突触测量技术。不过，由于 3DSPG 也能在随访期间提供与 CT 测量相当的可靠测量结果，因此在比较中并未发现明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Turkish neurosurgery 医学-临床神经学

CiteScore

1.50

自引率

12.50%

发文量

126

审稿时长

2 months

期刊介绍： Turkish Neurosurgery is a peer-reviewed, multidisciplinary, open access and totally free journal directed at an audience of neurosurgery physicians and scientists. The official language of the journal is English. The journal publishes original articles in the form of clinical and basic research. Turkish Neurosurgery will only publish studies that have institutional review board (IRB) approval and have strictly observed an acceptable follow-up period. With the exception of reference presentation, Turkish Neurosurgery requires that all manuscripts be prepared in accordance with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.