Department of Surgical Sciences, Plastic Surgery, Uppsala University.
Department of Information Technology, Centre for Image Analysis, Uppsala University.
J Craniofac Surg. 2021;32(1):113-117. doi: 10.1097/SCS.0000000000007087.
Secondary Coronal Synostosis (SCS) in patients operated for non-syndromic Sagittal Craniosynostosis is a postoperative phenomenon with unclear implications. The aim of this study was to investigate whether SCS is a negative or a benign occurrence in the postoperative course. The authors hypothesized that SCS is related to reduced cranial growth and intracranial hypertension. Thirty-one patients operated for SC at an early age with the H-craniectomy technique were included in the study. Associations between SCS and cranial shape, growth, and signs of intracranial hypertension were analyzed. Intracranial volume distribution was assessed by measuring partial intracranial volumes defined by skull base landmarks. A total of 12/31 patients developed SCS during the postoperative course. The presence of SCS was associated with a higher prevalence of gyral impressions and a larger normalization of Cranial Index due to less growth in the anteroposterior plane. The SCS group had a smaller postoperative intracranial volume due to less posterior intracranial volume as well as less growth in head circumference. Whether this is a growth restriction caused by the SCS or a secondary effect of less primary brain growth remains to be determined. However, the correlation between SCS, less cranial growth and gyral impressions does imply that SCS should be taken into consideration during clinical follow-up as a potentially adverse event.
继发冠状缝早闭（SCS）在非综合征性矢状缝早闭患者中是一种术后现象，其影响尚不清楚。本研究旨在探讨 SCS 在术后过程中是负面的还是良性的。作者假设 SCS 与颅骨生长受限和颅内高压有关。本研究纳入了 31 例采用 H 型颅骨切开术治疗的早期矢状缝早闭患者。分析了 SCS 与颅骨形状、生长和颅内高压的迹象之间的关系。通过测量颅底标志定义的部分颅内体积来评估颅内体积分布。共有 12/31 例患者在术后出现 SCS。SCS 的存在与脑回压迹的发生率更高以及由于前后平面生长减少导致颅指数的正常化更大有关。SCS 组的术后颅内体积较小，因为后颅内容积较小，头围增长也较少。这是 SCS 引起的生长受限还是原发性脑生长较少的继发效应仍有待确定。然而，SCS、颅骨生长受限和脑回压迹之间的相关性表明，在临床随访中应考虑 SCS 作为潜在的不良事件。
