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Establishing the Pediatric Head Circumference Growth Curve for Patients with Sagittal Craniosynostosis
Justin Beiriger, Casey Zhang, Nicolas M. Kass, Angel Dixon, Joseph Mocharnuk, Jeffrey Chen, Megan Pencek, Joseph Losee, Jesse Goldstein
UPMC Children's Hospital of Pittsburgh
2024-01-15
Presenter: Justin Beiriger
Affidavit:
Yes
Director Name: Jesse Goldstein
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction: Head circumference is an integral measurement of pediatric care and helps to diagnose conditions that result in increased intracranial pressure or growth restriction, among others. However, no comparable growth curve exists for patients with sagittal synostosis. Our study aims to generate standardized, validated growth curves for patients diagnosed with isolated sagittal craniosynostosis.
Methods: Patients diagnosed with isolated sagittal craniosynostosis between 2004-2022 were analyzed. Smoothed, LOESS non-parametric curves of head circumference were generated preoperatively and postoperatively. They were further stratified into three groups by treatment approach: Group 1 (no surgery), Group 2 (minimally invasive surgery), and Group 3 (open vault surgery).
Results: 241 patients were included, 76.8% male. 39.8% of patients were managed non-surgically, 35.3% with minimally invasive endoscopic surgery, and 24.9% with open cranial vault reconstruction. Average age at surgery was 0.5 and 2.8 years for Group 2 and Group 3, respectively. Growth curves extended to 7 years of age for Group 1, 5.75 years for Group 2, and 3.5 years for Group 3. In non-operative patients, the 50th percentile at 0.5 years of age was equivalent to between the 3rd and 5th percentile according to the CDC's growth curves for healthy infants. At 1.0 year of age, the 50th percentile circumference was equivalent to between the 50th and 75th percentiles for healthy infants.
Conclusion: Our study establishes a head circumference growth curve for patients with isolated sagittal craniosynostosis and will generate future studies to leverage head circumference as an important clinical metric in the care of these patients.
