Timing of cranial vault remodeling in nonsyndromic craniosynostosis: A single-institution 30-year experience

Alan F. Utria, Joseph Lopez, Regina S. Cho, Gerhard S. Mundinger, George I. Jallo, Edward S. Ahn, Craig Vander Kolk, Amir H. Dorafshar

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Due to the changing properties of the infant skull, there is still no clear consensus on the ideal time to surgically intervene in cases of nonsyndromic craniosynostosis (NSC). This study aims to shed light on how patient age at the time of surgery may affect surgical outcomes and the subsequent need for reoperation. METHODS: A retrospective cohort review was conducted for patients with NSC who underwent primary cranial vault remodeling between 1990 and 2013. Patients' demographic and clinical characteristics and surgical interventions were recorded. Postoperative outcomes were assessed by assigning each procedure to a Whitaker category. Multivariate logistic regression analysis was performed to determine the relationship between age at surgery and need for minor (Whitaker I or II) versus major (Whitaker III or IV) reoperation. Odds ratios (ORs) for Whitaker category by age at surgery were assigned. RESULTS: A total of 413 unique patients underwent cranial vault remodeling procedures for NSC during the study period. Multivariate logistic regression demonstrated increased odds of requiring major surgical revisions (Whitaker III or IV) in patients younger than 6 months of age (OR 2.49, 95% CI 1.05-5.93), and increased odds of requiring minimal surgical revisions (Whitaker I or II) in patients older than 6 months of age (OR 2.72, 95% CI 1.16-6.41). CONCLUSIONS: Timing, as a proxy for the changing properties of the infant skull, is an important factor to consider when planning vault reconstruction in NSC. The data presented in this study demonstrate that patients operated on before 6 months of age had increased odds of requiring major surgical revisions.

Original languageEnglish (US)
Pages (from-to)629-634
Number of pages6
JournalJournal of Neurosurgery: Pediatrics
Volume18
Issue number5
DOIs
StatePublished - Nov 2016

Keywords

  • Cranial vault remodeling
  • Craniofacial surgery
  • Craniosynostosis
  • Nonsyndromic
  • Sutures
  • Synostosis

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Timing of cranial vault remodeling in nonsyndromic craniosynostosis: A single-institution 30-year experience'. Together they form a unique fingerprint.

Cite this