<< Back to the abstract archive
Skull Vertex Position as A Novel Craniometric Measurement to Assess Severity and Surgical Outcomes in Sagittal Craniosynostosis
Samantha G. Maliha MD MS & Madeleine K. Bruce BA, Casey Zhang BA, Allison Mak BA, Justin W. Beiriger BSE, Lucas A. Dvoracek MD, Jesse Goldstein MD
University of Pittsburgh Medical Center
2022-01-05
Presenter: Madeleine Bruce
Affidavit:
Vu Nguyen
Director Name: Vu Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background:
Sagittal craniosynostosis (SCS) is the most common form of craniosynostosis, leading to scaphocephaly and, if untreated, potential neurologic sequelae affecting vision, hearing, respiration, and cognitive development. Surgical correction attempts to increase biparietal diameter and caudally reposition the cranial vertex. The purpose of this study is to define a novel measurement, skull vertex position, in patients who underwent cranioplasty for SCS to assess craniometric and aesthetic outcomes.
Methods:
Patients with a history of isolated, nonsyndromic SCS who underwent open vault cranial reconstruction at a tertiary care children's hospital from 2009-2020 were included. Cases were age and gender-matched to patients without any cranial bony pathology. Craniometric analysis, cranial index (CI) and the novel skull vertex position, was performed on pre- and postoperative CTs using Analyze Pro (V12, Overland Park, Kansas).
Results:
Twenty-four patients met inclusion criteria (87.5% male); 13 patients had an additional long-term follow-up CT. There were significant differences in both the CI and vertex position when comparing controls with pre-operative patients with SCS (p<0.001). There was significant improvement in caudal repositioning of the vertex from pre- to post-operative analysis, 0.43 and 0.51, respectively (p<0.001). Compared to pre-operative position, the vertex showed persistent improvement at long term follow-up, 0.43 versus 0.49, respectively (p=0.035).
Conclusion:
CI is the current standard measure of severity and postoperative outcomes in SCS. Our study introduces a novel measurement, skull vertex position, as an objective and reproducible measure for guidance in surgical planning and outcome assessment to maximize aesthetic and clinical outcomes.
