Experiences of surgical complications and reoperations in nonsyndromic sagittal synostosis patients in Oulu

Childs Nerv Syst. 2024 Dec;40(12):3983-3991. doi: 10.1007/s00381-024-06519-0. Epub 2024 Jun 28.

Abstract

Objective: The purpose of this study was to evaluate the surgical complications of patients treated for nonsyndromic sagittal craniosynostosis and the necessity for reoperations due to craniocerebral disproportion.

Materials and methods: The patient cohort of this study consisted of patients (N = 82) who were treated in the Oulu University Hospital using the open vault cranioplasty with a modified H-technique between the years 2008 to 2022. There were 69 males (84.1%) and 13 females (15.9%). The mean age at the primary operation was 6.1 months. Mean follow-up time was 9.0 years.

Results: There were no major complications related to the procedures. Two patients (2.4%) had a minor dural lesion. There were no postoperative wound infections. Of the 82 patients, seven patients with primary craniosynostosis (13.0%) developed symptomatic craniocerebral disproportion requiring reoperation to increase intracranial volume. In all these patients, invasive intracranial pressure (ICP) monitoring was performed prior to decision-making. In the majority of cases, the aesthetical outcome was considered good or excellent.

Conclusion: The operative method used was feasible and safe. Thirteen percent of patients who were followed over 5 years required major surgery due to development of craniocerebral disproportion later in life.

Keywords: Aesthetical result; Comorbidity; Craniocerebral disproportion; Scaphocephaly.

MeSH terms

  • Child
  • Child, Preschool
  • Cohort Studies
  • Craniosynostoses* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Plastic Surgery Procedures* / adverse effects
  • Plastic Surgery Procedures* / methods
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Reoperation*
  • Retrospective Studies
  • Treatment Outcome