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J Craniofac Surg ; 30(2): 453-457, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30640858

RESUMO

BACKGROUND: Bilateral coronal craniosynostosis is the premature fusion of both coronal sutures. Traditionally, this condition is treated by frontal-orbital advancement (FOA). Endoscopic strip craniectomy with cranial orthotic therapy, which has gained popularity in treating single suture craniosynostosis, has recently been adapted for the treatment of bicoronal synostosis. There have been few studies documenting the outcomes of this treatment. The objective of this study is to compare the morphological outcomes of endoscopic strip craniectomy and FOA in patients with bicoronal synostosis. METHODS: A retrospective case series was done on 24 patients with bilateral coronal synostosis treated with endoscopic strip craniectomy or FOA at 2 institutions. Patients with preoperative and 1-year postoperative computed tomography scans were included. Multiple measures of cranial shape and size were assessed: cephalic index, turricephaly index, basofrontal angle, circumference Z-score, and cranial vault volume Z-score. RESULTS: The 2 groups were similar statistically in terms of morphology at preoperative scan. There were no statistical differences between the FOA group and endoscopic group at postoperative scan in any of the morphologic outcomes measured. Cranial vault volume Z-scores increased postoperatively in both the endoscopic (P < 0.001) and FOA (P = 0.034) groups. CONCLUSIONS: One year after repair there were no significant morphological difference between patients with bicoronal synostosis treated with the endoscopic approach and those treated by FOA.


Assuntos
Craniossinostoses , Craniotomia , Endoscopia , Complicações Pós-Operatórias , Pesquisa Comparativa da Efetividade , Suturas Cranianas/diagnóstico por imagem , Suturas Cranianas/cirurgia , Craniossinostoses/diagnóstico , Craniossinostoses/cirurgia , Craniotomia/efeitos adversos , Craniotomia/métodos , Endoscopia/efeitos adversos , Endoscopia/métodos , Feminino , Seguimentos , Humanos , Lactente , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/instrumentação , Procedimentos de Cirurgia Plástica/métodos , Estudos Retrospectivos , Crânio/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
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