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A Single Surgeon’s 30-Year Experience of Total Vault Remodeling in the Treatment of Sagittal Craniosynsostosis: A Compilation of Perioperative Outcomes, Complications, and Long-Term Results in Skeletal Maturity
Larry A. Sargent, MD, Devan Griner, MD, Timothy A. Strait, MD.
Univ of Tennessee, Chattanooga, TN, USA.

PURPOSE:
The treatment of sagittal craniosynostosis has evolved into 3 categories of treatments including strip craniectomies, cranial vault remodeling (CVR), and newer minimally invasive techniques. Still, there is no gold standard treatment. This is in part due to the many different methods of CVR, disagreements as to the timing of operation, and few studies showing skeletally mature results in both minimally invasive and CVR procedures. The purpose of this study is to present our refined method of CVR, our safety data, and our long-term results.br>
METHODS:
A retrospective review of patients treated by a single surgeon between 1983 -2013. Demographic information, perioperative data, complications, anthropometric data, and photographic results were collected.br>
RESULTS:
Over 200 sagittal reconstructions were performed over the study period. The average surgical age was 10.3 months. Total hospital /ICU days averaged 5.4 and 2.1 respectively with trends toward shorter stays in the last 10 years. Average operative time was 2h 31min. 26% needed transfusions post-operatively. Complications included subdural hematoma, cellulitis, seroma, and sinus bleeding - all less than 1% and without permanent sequelae. There were no deaths. Reoperative rates for boney defects/contour irregularities were 0. Skeletally mature patients maintained good cosmetic results and normal anthropometics.br>
CONCLUSION:
Total vault remodeling by our described technique can be done quickly, safely, and provide excellent long-term outcomes without the need for reoperation for contour irregularities or bony defects. It is important for other senior authors to present their long-term results to help set baseline standards as newer methods are being introduced.br>


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