%0 Journal Article
%T The Effect of Barrel-Stave Osteotomy Length in Sagittal Strip Craniectomy.
%A Harrison LM
%A Prezelski K
%A Hallac RR
%A Sanati-Mehrizy P
%J Cleft Palate Craniofac J
%V 0
%N 0
%D 2024 Aug 12
%M 39135453
%F 1.915
%R 10.1177/10556656241275964
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>A retrospective review of operative records and pre-operative and one-year post-operative three-dimensional images.<BR><B>METHODS: </B>Tertiary care pediatric institution.<BR><B>METHODS: </B>Forty-five patients with sagittal craniosynostosis.<BR><B>METHODS: </B>Sagittal strip craniectomy and either long, medium, or short barrel-stave osteotomy lengths followed by helmet therapy.<BR><B>METHODS: </B>Operative and three-dimensional craniometric outcomes.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.