Comparison of Intracranial Volume and Cephalic Index After Correction of Sagittal Synostosis With Spring-assisted Surgery or Pi-plasty

2016 ◽  
Vol 27 (2) ◽  
pp. 410-413 ◽  
Author(s):  
Sara Fischer ◽  
Giovanni Maltese ◽  
Peter Tarnow ◽  
Emma Wikberg ◽  
Peter Bernhardt ◽  
...  
Keyword(s):  
Intracranial Volume ◽  
Cephalic Index ◽  
Sagittal Synostosis

Intracranial Volume and Cephalic Index Outcomes for Total Calvarial Reconstruction among Nonsyndromic Sagittal Synostosis Patients

2008 ◽  
Vol 121 (1) ◽  
pp. 187-195 ◽  
Author(s):  
Justin B. Heller ◽  
Misha M. Heller ◽  
Bianca Knoll ◽  
Joubin S. Gabbay ◽  
Charles Duncan ◽  
...  
Keyword(s):  
Intracranial Volume ◽  
Cephalic Index ◽  
Sagittal Synostosis

scholarly journals Regression of cephalic index following endoscopic repair of sagittal synostosis

2019 ◽  
Vol 23 (1) ◽  
pp. 54-60
Author(s):  
Nicholas A. Pickersgill ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Matthew D. Smyth ◽  
Kamlesh B. Patel
Keyword(s):  
Time Course ◽  
Strong Positive Correlation ◽  
Cephalic Index ◽  
Sagittal Synostosis ◽  
Endoscopic Repair ◽  
Future Studies ◽  
Helmet Therapy ◽  
Significant Regression ◽  
Strip Craniectomy

OBJECTIVEMetrics used to quantify preoperative severity and postoperative outcomes for patients with sagittal synostosis include cephalic index (CI), the well-known standard, and the recently described adjusted cephalic index (aCI), which accounts for altered euryon location. This study tracks the time course of these measures following endoscopic repair with orthotic helmet therapy. The authors hypothesize that CI and aCI show significant regression following endoscope-assisted repair.METHODSCT scans or 3D photographs of patients with nonsyndromic sagittal synostosis treated before 6 months of age by endoscope-assisted strip craniectomy and postoperative helmet therapy (n = 41) were reviewed retrospectively at three time points (preoperatively, 0–2 months after helmeting, and > 24 months postoperatively). The CI and aCI were measured at each time point.RESULTSMean CI and aCI increased from 71.8 to 78.2 and 62.7 to 72.4, respectively, during helmet treatment (p < 0.001). At final follow-up, mean CI and aCI had regressed significantly from 78.2 to 76.5 and 72.4 to 69.7, respectively (p < 0.001). The CI regressed in 33 of 41 cases (80%) and aCI in 39 of 41 cases (95%). The authors observed a mean loss of 31% of improvement in aCI achieved through treatment. A strong, positive correlation existed between CI and aCI (R = 0.88).CONCLUSIONSRegression following endoscope-assisted strip craniectomy with postoperative helmet therapy commonly occurs in patients with sagittal synostosis. Future studies are required to determine whether duration of helmet therapy or modifications in helmet design affect regression.

Cephalic index correlates poorly with intracranial volume in non-syndromic scaphocephalic patients

2014 ◽  
Vol 30 (12) ◽  
pp. 2097-2102 ◽  
Author(s):  
Junnu Leikola ◽  
Virve Koljonen ◽  
Arja Heliövaara ◽  
Jyri Hukki ◽  
Mika Koivikko
Keyword(s):  
Intracranial Volume ◽  
Cephalic Index

Comparison of aesthetic outcomes between open and endoscopically treated sagittal craniosynostosis

2021 ◽  
pp. 1-7
Author(s):  
Jacob Lepard ◽  
S. Hassan A. Akbari ◽  
James Mooney ◽  
Anastasia Arynchyna ◽  
Samuel G. McClugage III ◽  
...  
Keyword(s):  
Head Circumference ◽  
Endoscopic Treatment ◽  
Open Repair ◽  
Perioperative Outcomes ◽  
Subjective Rating ◽  
Cephalic Index ◽  
Sagittal Synostosis ◽  
Sagittal Craniosynostosis ◽  
Subjective Assessments ◽  
Z Scores

OBJECTIVE In the last several decades, there has been much debate regarding the ideal treatment for sagittal synostosis. The purpose of this study was to compare perioperative, anthropometric, and subjective assessments of cosmetic outcomes between open and endoscopic management of isolated sagittal synostosis. METHODS At their routine postoperative follow-up, pediatric patients with sagittal craniosynostosis were recruited to undergo digital cranial measurement and standardized photography for objective and subjective assessments of perioperative outcomes. Age-normalized z-scores for cephalic index, head circumference, euryon-euryon diameter (Eu-Eu), and glabella-opisthocranion diameter (G-Op) were calculated for each patient. Faculty surgeons, surgical trainees, nurses, and laypersons were asked to rate the normalcy of craniofacial appearances using a 5-point Likert scale. Outcomes were compared between patients treated with endoscopic correction and those treated with open repair. RESULTS A total of 50 patients were included in the study. Thirty-one had undergone open surgical correction, and 19 had undergone endoscopic treatment. Endoscopic repair involved significantly lower operative time, blood loss, transfusion rate, and hospital length of stay than those with open repair (p < 0.001). There was no significant difference between groups in terms of z-scores for head circumference (p = 0.22), cephalic index (p = 0.25), or Eu-Eu (p = 0.38). Endoscopic treatment was associated with a significantly lower G-Op (p = 0.009). Additionally, the average subjective rating of head shape was higher for endoscopic treatment when corrected for age, gender, and ethnicity (p = 0.02). CONCLUSIONS The study findings suggest that patients who are treated endoscopically may have an overall more normal appearance in skull morphology and cosmesis, although these results are limited by poor reliability.

Comparing Cephalic Index and Midsagittal Vector Analysis in Assessing Morphology in Sagittal Synostosis: A CT-Based Morphometric Analysis

2018 ◽  
Vol 56 (7) ◽  
pp. 944-952
Author(s):  
Brian Y. Hong ◽  
Emily S. Ho ◽  
Elizabeth Zellner ◽  
John H. Phillips ◽  
Christopher R. Forrest
Keyword(s):  
Discriminant Validity ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Vector Analysis ◽  
Control Group ◽  
Global Rating ◽  
Cephalic Index ◽  
Sagittal Synostosis ◽  
Ct Evaluation ◽  
The Difference

Introduction: Assessment of cranial dysmorphism in sagittal synostosis is often subjective but objective measures can be applied. These include cephalic index (CI) and midsagittal vector analysis (MSVA). Objective: To assess discriminant validity, construct validity, and responsiveness of CI and MSVA measured from computed tomography (CT) in patients with sagittal synostosis. Methods: Patients with nonsyndromic isolated sagittal synostosis with complete preoperative (n = 30) and postoperative (n = 13) CT data were included. Age-matched control group (n = 24) comprised of normocephalic patients who underwent CT for reasons related to trauma. Outcome Measures: Retrospective CT evaluation of CI and MSVA was conducted and correlated with a dysmorphism numeric rating scale (D-NRS) that measured surgeon-rated severity of sagittal synostosis. Responsiveness of CI and MSVA was evaluated using dysmorphism global rating of change (D-GRC). Results: Thirty patients with sagittal synostosis were demographically similar to 24 normocephalic patients. The difference in CI and MSVA was statistically significant between normocephalic and scaphocephalic patients. Cephalic index had a good correlation with D-NRS ( r = −0.665, ρ = −0.667), but not with MSVA ( r = 0.250, ρ = 0.203). Change in CI ( r = 0.738, ρ = 0.657) was well correlated with D-GRC, but not with MSVA ( r = −0.409, ρ = −0.301). Conclusion: Cephalic index appears to quantify the severity of sagittal synostosis better than MSVA. Cephalic index also has better responsiveness than MSVA to measure a reduction in severity of disease; however, MSVA is a better descriptive craniometric measurement. Midsagittal vector analysis was able to quantify the shift in morphology in sagittal synostosis following surgical treatment.

scholarly journals Improved cephalic index following early cranial vault remodeling in patients with isolated nonsyndromic sagittal synostosis

2021 ◽  
Vol 50 (4) ◽  
pp. E7
Author(s):  
Arvid Frostell ◽  
Maryam Haghighi ◽  
Jiri Bartek ◽  
Ulrika Sandvik ◽  
Bengt Gustavsson ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Cranial Vault ◽  
Hospital Length Of Stay ◽  
Cephalic Index ◽  
Sagittal Synostosis ◽  
The Mean ◽  
Cranial Vault Remodeling

OBJECTIVE Isolated nonsyndromic sagittal synostosis (SS) is the most common form of craniosynostosis in children, accounting for approximately 60% of all craniosynostoses. The typical cranial measurement used to define and follow SS is the cephalic index (CI). Several surgical techniques have been suggested, but agreement on type and timing of surgery is lacking. This study aimed to evaluate the authors’ institutional experience of surgically treating SS using a modified subtotal cranial vault remodeling technique in a population-based cohort. Special attention was directed toward the effect of patient age at time of surgery on long-term CI outcome. METHODS A retrospective analysis was conducted on all patients with isolated nonsyndromic SS who were surgically treated from 2003 to 2011. Data from electronic medical records were gathered. Eighty-two patients with SS were identified, 77 fulfilled inclusion criteria, and 72 had sufficient follow-up data and were included. CI during follow-up after surgery was investigated with ANOVA and a linear mixed model. RESULTS In total, 72 patients were analyzed, consisting of 16 females (22%) and 56 males (78%). The mean ± SD age at surgery was 4.1 ± 3.1 months. Blood transfusions were received by 81% of patients (26% intraoperatively, 64% postoperatively, 9% both). The mean ± SD time in the pediatric ICU was 1.1 ± 0.25 days, and the mean ± SD total hospital length of stay was 4.6 ± 2.0 days. No patient required reoperation. The mean ± SD CI increased from 69 ± 3 to 87 ± 5 for patients who underwent surgery before 45 days of age. Surgery resulted in a larger increase in CI for patients who underwent surgery at a younger age compared with older patients (p < 0.05, Tukey’s HSD test). In the comparison of patients who underwent surgery before 45 days of age with patients who underwent surgery at 45–90, 90–180, and more than 180 days of age, the linear mixed model estimated a long-term loss of CI of 3.0, 5.5, and 7.4 points, respectively. CONCLUSIONS The modified subtotal cranial vault remodeling technique used in this study significantly improved CI in patients with SS. The best results were achieved when surgery was performed early in life.

Combined metopic and sagittal craniosynostosis: is it worse than sagittal synostosis alone?

2011 ◽  
Vol 31 (2) ◽  
pp. E2 ◽  
Author(s):  
Jordan S. Terner ◽  
Roberto Travieso ◽  
Su-shin Lee ◽  
Antonio J. Forte ◽  
Anup Patel ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Brain Volume ◽  
Ventricular Volume ◽  
Brain Dysfunction ◽  
Volume Reduction ◽  
Intracranial Volume ◽  
Age Group ◽  
Sagittal Synostosis ◽  
Sagittal Craniosynostosis ◽  
Patient Groups

Object Combined metopic and sagittal craniosynostosis is a common variant of the nonsyndromic, multiplesuture synostoses. It is unknown whether this combined form causes reduced intracranial volume (ICV) and potentially more brain dysfunction than sagittal synostosis alone. This study is a volumetric comparison of these 2 forms of craniosynostosis. Methods The authors conducted a retrospective chart and CT review of 36 cases of isolated sagittal synostosis or combined metopic and sagittal synostosis, involving patients seen between 1998 and 2006. Values were obtained for the intracranial compartment, brain tissue, CSF space, and ventricular volumes. Patients with craniosynostosis were then compared on these measures to 39 age- and sex-matched controls. Results In patients with isolated sagittal synostosis and in those with combined metopic and sagittal synostosis, there was a trend toward smaller ICV than in controls (p < 0.1). In female patients older than 4.5 months of age, there was also a trend toward smaller ICV in patients with the combined form than in those with sagittal synostosis alone (p < 0.1), and the ICV of patients with the combined form was significantly smaller than the volume in controls in the same age group (p < 0.05). Brain tissue volume was significantly smaller in both patient groups than in controls (p < 0.05). Ventricular volume was significantly increased (compared with controls) only in the patients with isolated sagittal synostosis who were younger than 4.5 months of age (p < 0.05). Overall CSF space, however, was significantly larger in both patient groups in patients younger than 4.5 months of age (p < 0.05). Conclusions These findings raise concerns about intracranial and brain volume reduction in patients with sagittal and combined metopic and sagittal synostoses and the possibility that this volume reduction may be associated with brain dysfunction. Because the ICV reduction is greater in combined metopic and sagittal synostosis in patients older than 4.5 months of age than in sagittal synostosis in this age group, the potential for brain dysfunction may be particularly true for these younger infants.

Intracranial Volume Measured and Correlated to Cephalic Index in Syndromic and Nonsyndromic Anterior Brachycephaly

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Otto D.M. Kronig ◽  
Sophia A.J. Kronig ◽  
Léon N.A. Van Adrichem
Keyword(s):  
Intracranial Volume ◽  
Cephalic Index

Intracranial volume is normal in infants with sagittal synostosis

2014 ◽  
Vol 49 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Sara Fischer ◽  
Giovanni Maltese ◽  
Peter Tarnow ◽  
Emma Wikberg ◽  
Peter Bernhardt ◽  
...  
Keyword(s):  
Intracranial Volume ◽  
Sagittal Synostosis
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