Nonsyndromal craniosynostosis: longitudinal outcome following cranio-orbital reconstruction in infancy.

This paper presents a prospective longitudinal outcome study on patients with nonsyndromal craniosynostosis who were treated with the contemporary craniofacial surgical techniques of suture release, cranial decompression, and cranial and orbital reconstruction and reshaping in infancy. Diagnosis, surgical treatment, and long-term results and complications are reviewed. Preoperative and long-term postoperative intracranial volumes in these patients were evaluated and compared with age and gender match controls throughout the period of the study. From July 1, 1990, to July 1, 1994, 25 patients with isolated nonsyndromal craniosynostosis underwent surgery of the deformity. Eight patients were excluded from the study based on incomplete postoperative computed tomography (CT) records. Of the 17 patients with long-term computerized records, 11 were boys and 6 were girls. The nonsyndromal craniosynostosis patients in this study include six with bilateral coronal craniosynostosis, six with unilateral coronal craniosynostosis, four with sagittal craniosynostosis, and one with metopic craniosynostosis. The average age at the time of surgery for all patients was 9 months, and the average age at the time of the latest follow-up CT scan for all patients in the study was 3.5 years. There were no perioperative complications in this series of patients including no bleeding, no infection, no wound healing complications, and no mortality. Bony fixation included a combination of wire osteosynthesis and rigid microfixation. All patients had only one surgical procedure for the correction of their deformity. Evaluation of both preoperative and long-term postoperative intracranial volume measurements in this series of patients revealed that these volume measurements were comparable with the gender match control groups at all ages throughout the study. The significance of these findings for this longitudinal outcome study is discussed.