ASSESSMENT OF INTRACRANIAL VOLUME PRIOR AND AFTER SURGICAL CORRECTION IN PATIENTS WITH CRANIOSYNOSTOSIS

Main Article Content

Mohamed Ahmed Mohamed Ahmed Ali Eisa
Ahmed Kamel Khalifa
Mohamed Reda Abdelghani
Khaled Bassim Ali

Keywords

Craniosynostosis, Intracranial Volume, Surgical Correction, CT with 3D construction

Abstract

Background: Craniosynostosis (Craniostosis) is a congenital defect that causes ≥1 suture to fuse prematurely. Cranial expansion surgery is done to correct the skull to a more normal shape of the head as well as to increase the intracranial volume (ICV).


Aim and Objectives: To assess the intracranial volume (ICV) in craniosynostosis patients after the cranial reshaping surgeries and comparing the preoperative values with the postoperative and normal values.


 


Patients and Methods: This study included a list of all 130 patients who underwent craniosynostosis corrective surgeries and identified retrospectively and prospectively at Abu El-Rish Hospital during a 4-year window from 2017 to 2021.


 


Results:- There is a highly significant difference between the variables Pre and Post ICV, where p=0.002, p<0.01. for Males, ICV was 850, 1150, 1250 and 1350 cm3 at age of <12 months, 12 to 24, 24 to 36 and > 36 months respectively. For females, ICV was at lower values being at 790, 1000, 1200 and 1230 cm3 respecting the same age groups. “Pre ICV, Post ICV” are not significant, where (p = 0.990, p = 0.153) > 0.05, “Normal volume” is significant, where (p = 0.003).


 


Conclusions:- Measuring intracranial volume in early-presenting cases of craniosynostosis would be the cornerstone in determining the optimal time for surgery on clinical terms. Also, in late-presenting cases, recurrence would be predicted. Increased ICV allows better neurodevelopment and denies any delay.

Abstract 68 | PDF Downloads 38

References

1. Mathijssen IM. Guideline for care of patients with the diagnoses of craniosynostosis: working group on craniosynostosis. The Journal of craniofacial surgery. 2015 Sep;26(6):1735.
2. Speltz, Matthew L., et al. "Single-suture craniosynostosis: a review of neurobehavioral research and theory." Journal of pediatric psychology 29.8 (2004): 651-668.
3. Cohen, Steven R., et al. "American society of maxillofacial surgeon’s outcome study: preoperative and postoperative neurodevelopmental findings in single-suture craniosynostosis." Plastic and reconstructive surgery 114.4 (2004): 841-847.
4. Renier, Dominique, et al. "Intracranial pressure in craniostenosis." Journal of neurosurgery 57.3 (1982): 370-377.
5. Abdel-Alim T, Iping R, Wolvius EB, Mathijssen IM, Dirven CM, Niessen WJ, van Veelen ML, Roshchupkin GV. Three-dimensional stereophotogrammetry in the evaluation of craniosynostosis: current and potential use cases. Journal of Craniofacial Surgery. 2021 May 1;32(3):956-63.
6. Abdullah JY, Rajion ZA, Martin AG, Jaafar A, Ghani AR, Abdullah JM. Shape-based interpolation method in measuring intracranial volume for pre-and post-operative decompressive craniectomy using open source software. Neurocirugía (English Edition). 2019 May 1;30(3):115-23.
7. Sulong, Shukriyah, et al. "Intracranial volume post cranial expansion surgery using three-dimensional computed tomography scan imaging in children with craniosynostosis." Journal of Craniofacial Surgery 31.1 (2020): 46-50.
8. Panchal, Jayesh, et al. "Sagittal craniosynostosis outcome assessment for two methods and timings of intervention." Plastic and reconstructive surgery 103.6 (1999): 1574-1584.
9. Van Veelen, Marie-Lise C., et al. "Volume measurements on three-dimensional photogrammetry after extended strip versus total cranial remodeling for sagittal synostosis: A comparative cohort study." Journal of Cranio-Maxillofacial Surgery 44.10 (2016): 1713-1718.
10. Whitaker, Linton A., et al. "Craniosynostosis: an analysis of the timing, treatment, and complications in 164 consecutive patients." Plastic and reconstructive surgery 80.2 (1987): 195-206.
11. Netherway, David John, et al. "Intracranial volume in patients with nonsyndromal craniosynostosis." Journal of Neurosurgery: Pediatrics 103.2 (2005): 137-141.
12. Merritt, Linda. "Recognizing craniosynostosis." Neonatal Network 28.6 (2009): 369-376.
13. Thanapaisal, Chaiwit, Bowornsilp Chowchuen, and Prathana Chowchuen. "Craniofacial surgery for craniosynostosis: challenges in diagnosis, management and long-term outcome." J Med Assoc Thai 93.4 (2010): S24-S33.
14. Gandolfi, Brad M., et al. "Risk factors for delayed referral to a craniofacial specialist for treatment of craniosynostosis." The Journal of pediatrics 186 (2017): 165-171.
15. Kronig, Sophia AJ, et al. "New diagnostic approach of the different types of isolated craniosynostosis." European Journal of Pediatrics 180 (2021): 1211-1217.
16. Bredero-Boelhouwer, Hansje, Linda J. Treharne, and Irene MJ Mathijssen. "A triage system for referrals of pediatric skull deformities." Journal of Craniofacial Surgery 20.1 (2009): 242-245.
17. Breakey, William, et al. "Intracranial volume measurement: a systematic review and comparison of different techniques." Journal of Craniofacial Surgery 28.7 (2017): 1746-1751.
18. Foster, Kimberly A., David M. Frim, and McKay McKinnon. "Recurrence of synostosis following surgical repair of craniosynostosis." Plastic and reconstructive surgery 121.3 (2008): 70e-76e.
19. Baykal, Duygu, Rabia Nur Balçın, and M. Ozgur Taskapilioglu. "Amount of Recurrence Following Surgical Repair of Non-syndromic Craniosynostosis at Single Center." (2021).
20. Wall, S. A., et al. "Fronto-orbital re-operation in craniosynostosis." Journal of Craniofacial Surgery 7.3 (1996): 253.
21. McCarthy, Joseph G., et al. "Twenty-year experience with early surgery for craniosynostosis: I. Isolated craniofacial synostosis—results and unsolved problems." Plastic and reconstructive surgery 96.2 (1995): 272-283.
22. Senda, Daiki, et al. "Quantitative analysis of change in intracranial volume after posterior cranial vault distraction and frontal orbital advancement/remodeling." Journal of Craniofacial Surgery 30.1 (2019): 23-27.