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Craniotomy of the Fused Sagittal Suture Over the Superior Sagittal Sinus Is a Safe Procedure

Artikel i vetenskaplig tidskrift
Författare David Kölby
Sara Fischer
Khalid Arab
Giovanni Maltese
Robert Olsson
Anna Paganini
Peter Tarnow
Lars Kölby
Publicerad i Journal of Craniofacial Surgery
Volym 28
Nummer/häfte 3
Sidor 666-669
ISSN 1049-2275
Publiceringsår 2017
Publicerad vid Institutionen för kliniska vetenskaper, sektionen för kirurgi och kirurgisk gastroforskning, Avdelningen för plastikkirurgi
Sidor 666-669
Språk English
Länkar doi.org/10.1097/scs.000000000000344...
Ämnesord Craniosynostosis, osteotomy, pi-plasty, sagittal synostosis, spring, superior sagittal sinus, spring-mediated cranioplasty, pi-plasty, assisted surgery, synostosis, craniosynostosis, management, Surgery
Ämneskategorier Plastikkirurgi

Sammanfattning

Introduction: Spring-assisted cranioplasty to correct sagittal synostosis is based on midline craniotomy through the closed sagittal suture, over the superior sagittal sinus (SSS). The aim of the present study was to evaluate the perioperative safety of this technique. Materials and Methods: This is a retrospective study of all patients operated with median craniotomy and springs from 1998 to the end of 2015. For comparison, all Pi-plasties performed during the same time interval were also evaluated. The safety measures were evaluated based on incidence of damage to SSS, incidence of dural tears, perioperative blood loss, operative time, and hospital stay. Results: In the group that had undergone midline craniotomy combined with springs (n = 225), 4 perioperative damages to SSS and 1 dural tear were seen. The perioperative blood loss was 62.8 +/- 65.3mL (mean +/- standard deviation). The operative time was 67.9 +/- 21.5 minutes and the hospital stay was 4.8 +/- 1.1 days. In the group that had undergone pi-plasty (n = 105), no damages to SSS but 3 dural tears were seen. The perioperative blood loss was 352.8 +/- 174.4 mL. The operative time was 126.0 +/- 31.7 minutes and the hospital stay was 7.1 +/- 1.4 days. Conclusion: Craniotomy SSS in sagittal synostosis is a safe procedure with low morbidity in terms of damage to the SSS. Midline craniotomy combined with springs has significantly lower preoperative blood loss, operative time, and hospital stay (P < 0.001 for all) compared to pi-plasty.

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