From the Department of Plastic Surgery, Institute of Clinical Sciences, and Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital.
Plast Reconstr Surg. 2021 Feb 1;147(2):453-464. doi: 10.1097/PRS.0000000000007541.
Adaptive behavior skills are important when assessing cognitive functions related to daily life; however, few studies have assessed these skills in patients treated for nonsyndromic craniosynostosis. In this study, the authors assessed the adaptive behavior skills of children treated for craniosynostosis and examined whether their outcomes are related to surgical technique.
The Adaptive Behavior Assessment System, 2nd Edition, parent report was used for children (age, 7 to 16 years) treated for sagittal (n = 41), metopic (n = 24), and other rare synostoses (n = 8). Background data, including intelligence quotient, were controlled for confounders.
All evaluated children treated for craniosynostosis were estimated as lower in all aspects of adaptive behavior skills (full-scale, conceptual, social, and practical composites; effect size, 0.36 to 0.44) as compared with norms. The sagittal group showed shortcomings in social composite (effect size, 0.48) and subscales measuring self-care and self-direction, although no difference was observed between spring-assisted surgery and pi-plasty regarding outcomes of adaptive behavior skills. In addition, children treated for metopic synostosis showed results indicating shortcomings with adaptive behavior according to the full-scale, conceptual, and social composites (effect size, 0.53 to 0.61) relative to norms. Furthermore, attrition analysis revealed no significant differences between responders (rate, 80.2 percent) and nonresponders.
These results found that children treated for craniosynostosis display average adaptive behavior skills, and that the two surgical techniques used to treat sagittal synostosis did not differ in their behavioral outcomes.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
在评估与日常生活相关的认知功能时，适应行为技能很重要；然而，很少有研究评估过非综合征性颅缝早闭患者的这些技能。在这项研究中，作者评估了接受颅缝早闭治疗的儿童的适应行为技能，并研究了他们的治疗结果是否与手术技术相关。
使用《适应性行为评估系统》第 2 版，对接受矢状缝（n=41）、额缝（n=24）和其他罕见颅缝早闭（n=8）治疗的儿童（年龄 7 至 16 岁）的家长报告进行评估。背景数据，包括智商，被用来控制混杂因素。
与正常儿童相比，所有接受颅缝早闭治疗的儿童在适应行为技能的所有方面（全量表、概念、社会和实践综合评分；效应大小为 0.36 至 0.44）都被评估为较低。尽管在适应行为技能的治疗结果方面，没有观察到弹簧辅助手术和皮瓣成形术之间的差异，但矢状缝组在社会综合评分（效应大小为 0.48）和自我护理和自我导向子量表方面存在缺陷。此外，与正常儿童相比，接受额缝早闭治疗的儿童在全量表、概念和社会综合评分方面表现出适应行为技能不足（效应大小为 0.53 至 0.61）。此外，损耗分析显示，应答者（应答率为 80.2%）和无应答者之间没有显著差异。
这些结果表明，接受颅缝早闭治疗的儿童表现出平均的适应行为技能，用于治疗矢状缝早闭的两种手术技术在行为治疗结果方面没有差异。
临床问题/证据水平：治疗，III。
