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The Degree of Surgical Frontal Volume Correction in Metopic Synostosis Determines Long-Term Outcomes

Journal article
Authors Madiha Bhatti Söfteland
Giovanni Maltese
Peter Tarnow
Emma Wikberg
Peter Bernhardt
Lars Kölby
Published in Journal of Craniofacial Surgery
Volume 28
Issue 5
Pages 1161-1163
ISSN 1049-2275
Publication year 2017
Published at Institute of Clinical Sciences, Section for Oncology, Radiation Physics, Radiology and Urology, Department of Radiation Physics
Institute of Clinical Sciences, Section for Surgery and Gastrosurgical Research and Education, Department of Plastic Surgery
Pages 1161-1163
Language English
Links doi.org/10.1097/scs.000000000000358...
Keywords Cranioplasty, intracranial volume, metopic synostosis, single-suture craniosynostosis, school-age-children, intracranial, volume, orbital advancement, evolution, growth, Surgery, lashaw jb, 1986, neurosurgery, v19, p228
Subject categories Surgery

Abstract

Metopic synostosis results in a keel-shaped forehead, reduced frontal intracranial volume (ICV), and lower frontal to total volume ratio. The ratio improves with cranioplasty, but at 3 years of age, the ratio is still not normalized when compared to that in normal children. The aim of the present study was to investigate whether a low frontal to total ICV ratio at 3 years of age was due to relapse or insufficient correction.All children surgically treated for metopic synostosis in combination with a spring at Sahlgrenska University Hospital with subsequent spring extraction between 2002 and 2008 (n=20) were included. A MATLAB program was used to measure frontal and total ICV.Preoperatively, the frontal to total ICV ratio was 9.81.3% (mean +/- standard deviation). At spring removal, 6 months after cranioplasty, the ratio had increased to 11.8 +/- 2.4%. At 3 years of age, the ratio was 11.6 +/- 1.9%. In age-matched normal children, the ratio was 14.4 +/- 1.9% preoperatively, 15.3 +/- 2.2% at time of spring extraction, and 13.4 +/- 1.4% at 3 years of age.Cranioplasty thus improved the frontal to total ICV ratio, but did not normalize it. The ratio did not change from 6 months after the cranioplasty to 3 years of age. These results indicate that a more pronounced frontal volume correction during cranioplasty is necessary to achieve a normalized distribution of ICV in metopic synostosis.

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