<< Back to the abstract archive
A Treatment Protocol for Atypical Sagittal Craniosynostosis
Edward J Ruane, Jr, MD; Liliana Camison, MD; Regina A Fenton, MSN; Ian F Pollack, MD; Mandeep S Tamber, MD, PhD; Alexander J Davit, III, MD; Lorelei J Grunwaldt, MD; Joseph E Losee, MD; Jesse A Goldst
University of Pittsburgh Medical Center
2015-03-15
Presenter: Edward Ruane
Affidavit:
All of the work performed on this project represents the original work of the submitting resident.
Director Name: Joseph E Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Sagittal craniosynostosis is the most prevalent single-suture craniosynostosis and is typically diagnosed within the first year of life. Herein the authors highlight their experience with a challenging patient population: those with phenotypically mild, missed, or late-presenting sagittal craniosynostosis.
Methods: A retrospective chart review was conducted for all cases of sagittal craniosynostosis in our institution's Cleft-Craniofacial Center Database presenting between July 2013 and January 2015. Patients older than 1 year of age with isolated sagittal craniosynostosis were selected. All children are evaluated by craniofacial surgery, neurosurgery, and ophthalmology who perform dilated fundus examinations and visual evoked potential (VEP) testing.
Results: Thirty-five patients were identified who met inclusion criteria. Of these, only two patients had obvious scaphocephaly which was addressed surgically. Seven patients presented either with mild scaphocephaly, with signs of ICH in the setting of other potential causes, or with inconclusive ophthalmologic evaluation. These patients were admitted for intracranial pressure monitoring, of which two were found to be elevated (28.6 percent) and therefore taken to surgery. Twenty-two patients presented with isolated sagittal craniosynostosis in the setting of either overall normal head shape or a lack of any signs concerning for ICH. These patients continue to undergo serial ophthalmologic evaluation with normal optic disc appearance and VEPs to date.
Conclusions: The optimal treatment of patients presenting with atypical sagittal craniosynostosis is not well defined. A new treatment protocol based upon the authors' experience with this cohort of patients is therefore described.
