Page 162 - Demo

160Chapter10ABSTRACTThis retrospective cohort study evaluated the longitudinal three-dimensional(3D)cranialshapedevelopmentsandthesecondarytreatmentaspectsafterendoscopicallyassistedcraniosynostosissurgery(EACS)withhelmettherapyandopencranialvaultreconstruction(OCVR)forscaphocephalyLongitudinallycollected3Dphotosfromscaphocephalypatientsandhealthyinfants were evaluated 3D cranial shapemeasurements and growthmaps werecomparedbetween thegroupsover timeSecondary treatmentaspectswerecomparedforthetreatmentgroupsBothsurgicaltechniquesshowedtheirstrongestchangesdirectlyaftersurgerywithmeanparietal3Dgrowthsupto10mmAtage24monthscomparisonofheadshapesshowedmean3Ddifferenceslessthan±2mmwithOCVRresultinginalowervertexandlongercraniallengthwhencomparedtoEACSAt48monthsofagenomeasurementsweresignificantlydifferentbetweentreatmentgroupsOnlythetotalheadvolumewassomewhatlargerinthemaleEACSgroupatage48months(p=0046)BloodlossinEACS(mean18mlrange0-160ml)waslowerthaninOCVR(mean100mlrange15-300mlp<0001)MedianlengthofstayaftersurgerywasshorterforEACS(2daysrange1-5)comparedtoOCVR(5daysrange3-8p<0001)We conclude thatEACS for scaphocephaly shows equal craniometricresultsatage48monthsandhasabettersurgeryprofilecomparedtoOCVREarlydiagnosticsandreferralforsuspectedscaphocephalytoallowEACSisthereforerecommended