Annotated Bibliography #1: Early Management of Craniosynostosis Using Endoscopic-Assisted Strip Cran
The purpose of article, Early Management of Craniosynostosis Using Endoscopic-Assisted Strip Craniotomies and Cranial Orthotic Molding Therapy, is to “assess the safety, efficacy, and results of the early treatment of infants with Craniosynostosis using minimally invasive endoscopic strip craniotomies and postoperative helmet molding therapy” (Jimenez 1). First, the article discusses the surgical technique used in each type of Craniosynostosis. Along with the results and number of patients for each type of Craniosynostosis that the endoscopic procedure was used in (103 patients: 61 Sagittal synostosis, 20 Coronal synostosis, 18 Metopic synostosis, and 4 Lambdoid synostosis). There are multiple types of Craniosynostosis, this article talks about the results of the endoscopic surgery on synostosis: Sagittal, Coronal, Metopic, Lambdoid. The results show all patients had no complications with the procedure. “There were no infections, Dural sinus tears, cerebrospinal fluid leaks, or neurologic injuries, and there were no significant complications related to the use of the helmet” (Jimenez 1).
When comparing the traditional surgery, Calvarial Vault Remodeling, to the minimally invasive surgery, Endoscopic surgery, the Calvarial Vault Remodeling procedure is overall more complicated, risky, and expensive then the Endoscopic surgery. The Calvarial Vault remodeling procedure last 3-8 hours, tends to have problems associated with blood transfusions, postoperative intensive care units stay were 1-4 days. cost on average $39,000, and is done at an older age of 6-12 months. Also even after this procedure is done the shape of the calvarial can revert back. Along with this “Difficulties with carlvarial shape correction, improper skull re ossification, palpable and visible “bumps and lumps,” loosening of titanium screws and plates and/or wires, migration of screws into the brain parenchyma through the Dura, extensive blood losses, and problems associated with blood transfusion reactions. Surgical times range from 3 to 8 hours; postoperative intensive care unit stays may be up to a week in length” (Jimenez 2). While the Endoscopic procedure had almost no complications. The operative time was on average 1 hour, there was minimal blood lose, patients were discharged after 1-2 days, and the cost was very low compared to other surgical techniques. Along with this all patients (age 3-4 months) have or are achieving normal cranial shape. “These techniques have excellent results with extremely low morbidity and no mortalities and are associated with low need for blood transfusions, lower hospitalization costs, and shorter hospital stays” (Jimenez 7).
This article could be my starting point to begin research over early management of craniosynostosis. From this article, I can find new subtopics to look into to help me gain a better understanding and foundation over craniosynostosis. Perhaps I could begin learning how and why craniosynostosis develops, whether it is genetic or not. Also this article could then allow me to begin researching more recent clinical trials being done for new methods in treating craniosynostosis. By using this article and other articles over how Craniosynostosis develops and why, current clinical trials for Craniosynostosis, and speaking to the head of Orthotics at my mentorship (Children’s Healthcare of Atlanta) I will be able to conduct my research towards my essential question.
Jimenez, D. F., Barone, C. M., Cartwright, C. C., & Baker, L. (2002). Early
Management of Craniosynostosis Using Endoscopic-Assisted Strip
Craniectomies and Cranial Orthotic Molding Therapy. Pediatrics,
110(1), 97.