4.1 Article

Outcomes of endoscopic treatment for early correction of craniosynostosis in children: a 26-year single-center experience

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JOURNAL OF NEUROSURGERY
卷 32, 期 3, 页码 267-276

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AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/2023.4.PEDS22512

关键词

craniosynostosis; endoscope-assisted surgery; treatment; children; craniofacial

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This study compared the perioperative and reconstructive outcomes of endoscope-assisted surgery (EAS) and open surgery (OS) in children aged 5-6 months undergoing craniosynostosis correction. The results showed that EAS was associated with shorter estimated blood loss, lower transfusion requirements, shorter surgical time, and shorter hospital stay compared to OS. There was a positive correlation between surgical time and estimated blood loss. The percentage of cranial index correction at 12 months of follow-up did not differ between the two groups.
OBJECTIVE Surgery is the cornerstone of craniosynostosis treatment. In this study, two widely accepted techniques are described: endoscope-assisted surgery (EAS) and open surgery (OS). The authors compared the perioperative and reconstructive outcomes of EAS and OS in children 5 6 months of age treated at the Napoleon Franco Pareja Children's METHODS According to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement, patients with defined criteria who underwent surgery to correct craniosynostosis between June 1996 and June 2022 were retrospectively enrolled. Demographic data, perioperative outcomes, and follow-up were obtained from their medical records. Student t-tests were used for significance. Cronbach's alpha was used to assess agreement between estimated blood loss (EBL). Spearman's correlation coefficient and the coefficient of determination were used to establish associations between the results of interest, and the odds ratio was used to calculate the risk ratio of blood product transfusion. RESULTS A total of 74 patients met the inclusion criteria; 24 (32.4%) belonged to the OS group and 50 (67.6%) to the EAS group. There was a high interobserver agreement quantifying the EBL. The EBL, transfusion of blood products, surgical time, and hospital stay were shorter in the EAS group. Surgical time was positively correlated with EBL. There were no differences between the two groups in the percentage of cranial index correction at 12 months of follow-up. CONCLUSIONS Surgical correction of craniosynostosis in children aged 5 6 months by EAS was associated with a significant decrease in EBL, transfusion requirements, surgical time, and hospital stay compared with OS. The results of cranial deformity correction in patients with scaphocephaly and acrocephaly were equivalent in both study groups.

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