<< Back to the abstract archive
Minimal access anterior strip craniectomy and helmet therapy preferentially expands the posterior more than the anterior cranial vault in Apert patient with bicoronal craniosynostosis
Navid Pourtaheri, MD, PhD;
Anand R. Kumar, MD, FACS
Case Western Reserve University School of Medicine
2018-02-10
Presenter: Navid Pourtaheri, MD, PhD
Affidavit:
100% of the abstract submitted by Dr. Navid Pourtaheri represents his original work.
Director Name: Anand R. Kumar
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Purpose: To study the progression of head shape and anterior versus posterior vault dimensions after anterior endoscopic strip craniectomy (AESC) in a patient with Apert's syndrome.
Methods: A case study of a male patient with Apert's Syndrome was performed. Helmet therapy began at age 1.6 months, followed by AESC at age 2.8 months and fronto-orbital advancement (FOA) at 15.4 months. Last follow-up was at age 27.6 months. A STARscanner® Laser Data Acquisition System was used to create surface topographic maps of head shape throughout the study. Anteroposterior dimension, cephalic index (CI), head circumference, anterior and posterior cross-sectional areas, arc length in each quadrant, and radial symmetry index were computed from topographic maps.
Results: At the initiation of helmet therapy at age 1.6 months, CI was 1.056 and the posterior cross-sectional area (CSA) was 42% larger than the anterior vault. At the time of AESC at age 2.8 months, CI was 1.093 and the posterior CSA was 54% larger than the anterior vault. 10.8 months after AESC (age 13.6 months), CI was 0.930 and the posterior CSA was 79% larger than the anterior vault. At age 17.8 months, 2.5 months after FOA, CI was 0.865 and the posterior CSA was 52% larger than the anterior vault.
Conclusion: In this Apert patient, minimal access AESC with helmet therapy allowed for cranial expansion through preferential growth of the posterior vault while avoiding more invasive posterior vault expansion procedures. In combination with FOA, the cranium was adequately expanded and CI was corrected.
