<< Back to the abstract archive
Evaluating the Efficacy of Dynamic Cranial Vault Remodeling for the Treatment of Late Presenting Scaphocephaly: A Cohort Comparison Study Between Pi Cranioplasty and Subtotal Cranioplasty
S. Alex Rottgers, MD
Zoe MacIsaac, MD
Joseph Losee, MD
Ian Pollack MD
Mandeep Tamber, MD, PhD
Anand Kumar, MD
University of Pittsburgh
2013-03-14
Presenter: S. Alex Rottgers
Affidavit:
Radiographic and chart review, and and abstract drafting were completed by the resident
Director Name: Joseph E. Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose: Treatment of late presenting sagittal synostosis remains controversial. This study compares the ability of a dynamic Pi/ Hungspan cranioplasty (PHC) and non-dynamic subtotal cranioplasty (STC) to correct cranial disproportion and frontal bossing in patients over 12 months old.
Methods: A 6-year retrospective cohort study of late presenting sagittal synostosis patients (>12 months old) was performed comparing cranial index (CI) and naso-frontal angle (NFA) changes between patients treated with PHC and STC with CT data. Non-syndromic sagittal synostosis patients < 12 months old treated with reverse Pi craniopalsty (CONTROL) were used as a control.
Results: Six PHC patients (5 male and 1 female, age 59 months), 5 STC patients (4 male and 1 female, age 31 months), and 5 CONTROL patients (5 male and 0 female, age 7 months) were identified. The median PHC CI increased from 0.71 to 0.82 (p=0.028), STC CI increased from 0.67 to 0.71 (p=0.225), and CONTROL CI increased from 0.74 to 0.80 (p=0.008). Median delta-CI was significantly greater for PHC compared to STC (p=0.004) and CONTROL (p=0.004). The NFA significantly increased with both PHC and CONTROL (PHC; pre-op: 140.5, post-op: 143; p=0.046) (CONTROL; pre-op: 124; post-op: 139; p=0.042) but not with STC (pre-op: 140; post-op 140; p=0.713). NFA increased significantly more in CONTROL patients compared to STC (p=0.016) but not PHC (p=0.082).
Conclusions: PHC more effectively corrected CI than STC for late presenting scaphocephaly. PHC also better corrected CI than the younger CONTROL population. Dynamic cranioplasty in both younger and older cohorts significantly improved NFA.
