The Role of Preoperative Imaging in the Management of Nonsyndromic Lambdoid Craniosynostosis

Kavitha Ranganathan, Antonio Rampazzo, Asra Hashmi, Karin Muraszko, Jennifer Strahle, Christian J. Vercler, Steven R. Buchman

Research output: Contribution to journalArticle

Abstract

Background: The necessity of imaging for patients with craniosynostosis is controversial. Lambdoid synostosis is known to be associated with additional anomalies, but the role of imaging in this setting has not been established. The purpose of this study was to evaluate the impact of preoperative imaging on intraoperative and postoperative management among patients undergoing operative intervention for lambdoid craniosynostosis. Methods: A retrospective review of patients undergoing cranial vault remodeling for lambdoid craniosynostosis between January 2006 and 2014 was conducted. Patient demographics, age at computed tomography scan, age at surgery, results of the radiologic evaluation, operative technique, and modification of the diagnosis following the radiologic studies were analyzed. A pediatric neuroradiology and the surgical team interpreted the radiographs. The primary outcome was change in intraoperative or postoperative management based on imaging results. Results: A total of 11 patients were diagnosed with lambdoid synostosis. Of these patients, 81.8% had abnormalities on imaging relevant to operative planning. The most common anomalies were Chiari I malformation (45%) and venous anomalies of the posterior fossa (36%). Preoperative imaging altered the management of 9 (81.8%) patients. Closer follow-up was required for 6 patients (54%). Suboccipital decompression was performed in 4 patients (36%). Venous anomalies were found in 4 patients (36%). The diagnosis was changed from positional plagiocephaly to lambdoid synostosis in 2 patients (18%). Conclusions: Given the frequency and significance of radiographic abnormalities in the setting of lamboid synostosis, preoperative imaging should be considered during the operative planning phase as it can affect postoperative and intraoperative management.

Original languageEnglish (US)
Pages (from-to)36-39
Number of pages4
JournalJournal of Craniofacial Surgery
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

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Craniosynostoses
Nonsynostotic Plagiocephaly
Synostosis
Decompression
Tomography
Demography

Keywords

  • Craniosynostosis
  • lambdoid craniosynostosis
  • preoperative imaging

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

The Role of Preoperative Imaging in the Management of Nonsyndromic Lambdoid Craniosynostosis. / Ranganathan, Kavitha; Rampazzo, Antonio; Hashmi, Asra; Muraszko, Karin; Strahle, Jennifer; Vercler, Christian J.; Buchman, Steven R.

In: Journal of Craniofacial Surgery, Vol. 29, No. 1, 01.01.2018, p. 36-39.

Research output: Contribution to journalArticle

Ranganathan, Kavitha ; Rampazzo, Antonio ; Hashmi, Asra ; Muraszko, Karin ; Strahle, Jennifer ; Vercler, Christian J. ; Buchman, Steven R. / The Role of Preoperative Imaging in the Management of Nonsyndromic Lambdoid Craniosynostosis. In: Journal of Craniofacial Surgery. 2018 ; Vol. 29, No. 1. pp. 36-39.
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abstract = "Background: The necessity of imaging for patients with craniosynostosis is controversial. Lambdoid synostosis is known to be associated with additional anomalies, but the role of imaging in this setting has not been established. The purpose of this study was to evaluate the impact of preoperative imaging on intraoperative and postoperative management among patients undergoing operative intervention for lambdoid craniosynostosis. Methods: A retrospective review of patients undergoing cranial vault remodeling for lambdoid craniosynostosis between January 2006 and 2014 was conducted. Patient demographics, age at computed tomography scan, age at surgery, results of the radiologic evaluation, operative technique, and modification of the diagnosis following the radiologic studies were analyzed. A pediatric neuroradiology and the surgical team interpreted the radiographs. The primary outcome was change in intraoperative or postoperative management based on imaging results. Results: A total of 11 patients were diagnosed with lambdoid synostosis. Of these patients, 81.8{\%} had abnormalities on imaging relevant to operative planning. The most common anomalies were Chiari I malformation (45{\%}) and venous anomalies of the posterior fossa (36{\%}). Preoperative imaging altered the management of 9 (81.8{\%}) patients. Closer follow-up was required for 6 patients (54{\%}). Suboccipital decompression was performed in 4 patients (36{\%}). Venous anomalies were found in 4 patients (36{\%}). The diagnosis was changed from positional plagiocephaly to lambdoid synostosis in 2 patients (18{\%}). Conclusions: Given the frequency and significance of radiographic abnormalities in the setting of lamboid synostosis, preoperative imaging should be considered during the operative planning phase as it can affect postoperative and intraoperative management.",
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