1343. The Edmonton Experience: Five Year 3D CT Follow-up of Endoscopic Sagittal Craniosynostosis Repair

Authors: Amit Rahul Latchme Persad, MD; Amit Persad, MD; Vivek Mehta, MD (Saskatoon, Canada)

Introduction:

Surgical treatment of sagittal synostosis can involve various modalities of surgery. Follow-up for these children is contentious. Follow-up issues included cranial constraint, secondary craniosynostosis failure of reossification, and poor cosmesis.

Methods:

We reviewed 30 patients age less than 16 weeks undergoing endoscopic sagittal synostosis repair since 2006. A standard vertex craniectomy with biparietal wedges was done for each. All were helmeted to 8 months of age. These patients were followed to five years, at which point they had a 3D CT scan. We collected data on the cranial index, area of bony defect, presence or absence of secondary craniosynostosis, and scalloping of the inner table.

Results:

There was a small but significant recession of the cranial index of 0.03 (0.79 post helmet to 0.76 at 5 years). Of 30 children, 5 had bony defect area >8cm2. 3 children had secondary craniosynostosis (one left coronal, one right coronal, one bicoronal). 7/30 patients had partial neosuture formation. 2/30 children had scalloping of the inner table.

Conclusion:

We noted small but statistically significant recession of the cranial index, although it remained within a normal range. 5 children had skull defect >8cm2. 3 children had secondary craniosynostosis.