The Effects of Whole-Vault Cranioplasty versus Strip Craniectomy on Long-Term Neuropsychological Outcomes in Sagittal Craniosynostosis

被引:151
作者
Hashim, Peter W.
Patel, Anup
Yang, Jenny F.
Travieso, Roberto
Terner, Jordan
Losee, Joseph E.
Pollack, Ian
Jane, John, Sr.
Jane, John, Jr.
Kanev, Paul
Mayes, Linda
Duncan, Charles
Bridgett, David J.
Persing, John A.
机构
[1] Yale Univ, Sch Med, Sect Plast & Reconstruct Surg, New Haven, CT 06520 USA
[2] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA
[3] Univ Virginia, Sch Med, Dept Neurosurg, Charlottesville, VA 22903 USA
[4] Connecticut Childrens Med Ctr, Craniofacial Surg Ctr, Hartford, CT USA
[5] No Illinois Univ, Dept Psychol, De Kalb, IL 60115 USA
关键词
SINGLE-SUTURE CRANIOSYNOSTOSIS; COGNITIVE-DEVELOPMENT; NONSYNDROMIC CRANIOSYNOSTOSIS; ENDOSCOPIC CRANIECTOMY; MENTAL-DEVELOPMENT; INFANTS; SYNOSTOSIS; CHILDREN; NEURODEVELOPMENT; MANAGEMENT;
D O I
10.1097/PRS.0000000000000420
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The optimal type of surgical management for isolated sagittal synostosis remains a source of significant debate. There is a paucity of data regarding possible differences in long-term neuropsychological outcomes following treatment with whole-vault cranioplasty or endoscopic strip craniectomy. This study provides the first comparative analysis examining the effects of the two techniques related to long-term intellectual functioning. Methods: A total of 70 patients were enrolled in this multicenter study, 29 of whom had previously undergone endoscopic strip craniectomy and 41 of whom had previously undergone whole-vault cranioplasty. All patients completed a battery of neurodevelopmental tests (Beery-Buktenica Developmental Test of Visual-Motor Integration, Wechsler Abbreviated Scale of Intelligence, and Wechsler Fundamentals) to evaluate various domains of neuropsychological function. Results: In a group comparison of those treated before 6 months of age, whole-vault patients obtained higher scores relative to endoscopic strip craniectomy patients on visuomotor integration, full-scale intelligence quotient, verbal intelligence quotient, word reading, and reading comprehension (p < 0.05 for all). When compared against strip craniectomy performed before 3 months of age, the whole-vault group still showed significantly higher scores in verbal intelligence quotient, reading comprehension, and word reading (p < 0.05 for all). Conclusions: The type of surgical intervention for isolated sagittal synostosis impacts long-term neuropsychological outcomes. Patients undergoing early whole-vault cranioplasty attained higher intelligence quotient and achievement scores relative to those undergoing strip craniectomy. Surgical management with whole-vault cranioplasty performed before 6 months of age provides the most favorable long-term intellectual outcomes in patients with isolated sagittal synostosis.
引用
收藏
页码:491 / 501
页数:11
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