Abstract：
OBJECTIVE: In managing sagittal craniosynostosis, strip craniectomy of the affected suture is commonly paired with barrel-stave osteotomies to allow for additional cranial remodeling. However, the effect of these osteotomies is not well-established. This study aimed to evaluate the effect of the length of barrel-stave osteotomies on outcomes in patients with sagittal craniosynostosis.
METHODS: A retrospective review of operative records and pre-operative and one-year post-operative three-dimensional images.
METHODS: Tertiary care pediatric institution.
METHODS: Forty-five patients with sagittal craniosynostosis.
METHODS: Sagittal strip craniectomy and either long, medium, or short barrel-stave osteotomy lengths followed by helmet therapy.
METHODS: Operative and three-dimensional craniometric outcomes.
RESULTS: Operative time, estimated blood loss, and hospital length of stay were significantly decreased in the short group (P = .003; 0.002; 0.027). The cranial index was normalized in all groups, but the long group was significantly lower (P = .007; 0.025). Head circumference was similar between groups. All indexes were within the normal percentiles in all groups. The medium group had a significantly decreased scaphocephalic index (P = .031; .035). The short group had significantly greater occipital bulleting than the medium group (P = .001). The long group had significantly greater narrowing than the short group (P = .036).
CONCLUSIONS: Strip craniectomy with the addition of long, medium, or short barrel staves all resulted in clinically successful outcomes. Our findings suggest that increased barrel-stave osteotomy length may not be necessary for a successful outcome while avoiding more extensive dissection, potential risk, increased operative time, and hospital length of stay.
METHODS: A retrospective review of operative records and pre-operative and one-year post-operative three-dimensional images.
METHODS: Tertiary care pediatric institution.
METHODS: Forty-five patients with sagittal craniosynostosis.
METHODS: Sagittal strip craniectomy and either long, medium, or short barrel-stave osteotomy lengths followed by helmet therapy.
METHODS: Operative and three-dimensional craniometric outcomes.
RESULTS: Operative time, estimated blood loss, and hospital length of stay were significantly decreased in the short group (P = .003; 0.002; 0.027). The cranial index was normalized in all groups, but the long group was significantly lower (P = .007; 0.025). Head circumference was similar between groups. All indexes were within the normal percentiles in all groups. The medium group had a significantly decreased scaphocephalic index (P = .031; .035). The short group had significantly greater occipital bulleting than the medium group (P = .001). The long group had significantly greater narrowing than the short group (P = .036).
CONCLUSIONS: Strip craniectomy with the addition of long, medium, or short barrel staves all resulted in clinically successful outcomes. Our findings suggest that increased barrel-stave osteotomy length may not be necessary for a successful outcome while avoiding more extensive dissection, potential risk, increased operative time, and hospital length of stay.
摘要：
目的：在治疗矢状位颅骨融合时，受影响的缝合线的带状骨瓣切除术通常与筒形骨截骨术配对，以进行额外的颅骨重塑。然而,这些截骨术的效果尚不明确。本研究旨在评估截骨管长度对矢状位颅骨滑脱症患者预后的影响。
方法：回顾性回顾手术记录以及术前和术后一年的三维图像。
方法：三级护理儿科机构。
方法：45例矢状颅骨融合症患者。
方法：矢状面带状骨瓣切除术和长，中等,或短的桶形板条截骨长度，然后进行头盔治疗。
方法：手术和三维颅骨测量结果。
结果：手术时间，估计失血量,短期组住院时间明显缩短(P=.003;0.002;0.027)。所有组的颅骨指数均恢复正常，但长组显着更低（P=.007;0.025）。组间头围相似。所有组的所有指标均在正常百分位数范围内。中等组的头颅指数显着降低（P=.031；.035）。短组的枕骨大球明显大于中等组（P=0.001）。长组的狭窄程度明显大于短组（P=0.036）。
结论：带颅切除术增加了长，中等,或短的桶形长柄均导致临床上成功的结果。我们的研究结果表明，在避免更广泛的解剖的同时，增加桶形段截骨长度对于成功的结果可能不是必需的。潜在风险，增加手术时间，和住院时间。
方法：回顾性回顾手术记录以及术前和术后一年的三维图像。
方法：三级护理儿科机构。
方法：45例矢状颅骨融合症患者。
方法：矢状面带状骨瓣切除术和长，中等,或短的桶形板条截骨长度，然后进行头盔治疗。
方法：手术和三维颅骨测量结果。
结果：手术时间，估计失血量,短期组住院时间明显缩短(P=.003;0.002;0.027)。所有组的颅骨指数均恢复正常，但长组显着更低（P=.007;0.025）。组间头围相似。所有组的所有指标均在正常百分位数范围内。中等组的头颅指数显着降低（P=.031；.035）。短组的枕骨大球明显大于中等组（P=0.001）。长组的狭窄程度明显大于短组（P=0.036）。
结论：带颅切除术增加了长，中等,或短的桶形长柄均导致临床上成功的结果。我们的研究结果表明，在避免更广泛的解剖的同时，增加桶形段截骨长度对于成功的结果可能不是必需的。潜在风险，增加手术时间，和住院时间。
