Perioperative Comparison Between Open Cranial Vault Remodeling and Distraction Osteogenesis for Unilateral Lambdoid Craniosynostosis.

Autor:	Belza CC; UC San Diego, School of Medicine., Modi RN; UC San Diego, School of Medicine., Kamel GN; UC San Diego, Division of Plastic Surgery.; Rady Children's Hospital, San Diego, CA., McKee RM; UC San Diego, School of Medicine., Carbullido MK; University of Wisconsin School of Medicine and Public Health, Madison, WI., Kim E; UC San Diego, Division of Plastic Surgery.; Rady Children's Hospital, San Diego, CA., Gosman AA; UC San Diego, Division of Plastic Surgery.; Rady Children's Hospital, San Diego, CA.
Jazyk:	angličtina
Zdroj:	The Journal of craniofacial surgery [J Craniofac Surg] 2023 Jun 01; Vol. 34 (4), pp. 1222-1225. Date of Electronic Publication: 2023 Mar 13.
DOI:	10.1097/SCS.0000000000009227
Abstrakt:	There are multiple treatment options for unilateral lambdoid craniosynostosis (ULS) including open posterior cranial vault remodeling (OCVR) and distraction osteogenesis (DO). There is a paucity of data comparing these techniques in the treatment of ULS. This study compared the perioperative characteristics of these interventions for patients with ULS. An IRB-approved chart review was performed from January 1999 to November 2018 at a single institution. Inclusion criteria included the diagnosis of ULS, treatment with either OCVR or DO using a posterior rotational flap technique, and a minimum 1-year follow-up. Seventeen patients met the inclusion criteria (12 OCVR and 5 DO). Patients in each cohort were found to have a similar distribution in sex, age at the time of surgery, synostosis laterality, weight, and length of follow-up. There was no significant difference in mean estimated blood loss/kg, surgical time, or transfusion requirements between cohorts. Distraction osteogenesis patients had a longer mean hospital length of stay (3.4 +/- 0.6 d versus 2.0 +/- 0.6 d, P = 0.0004). All patients were admitted to the surgical ward postoperatively. In the OCVR cohort, complications included 1 dural tear, 1 surgical site infection, and 2 reoperations. In the DO cohort, 1 patient had a distraction site infection, treated with antibiotics. There was no significant difference in estimated blood loss, volume of blood transfusion, or surgical time between OCVR and DO. Patients who underwent OCVR had a higher incidence of postoperative complications and the need for reoperation. This data provides insight into the perioperative differences between OCVR and DO in patients with ULS. Competing Interests: The authors report no conflicts of interest. (Copyright © 2023 by Mutaz B. Habal, MD.)
Databáze:	MEDLINE
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