An Evaluation of Soft-tissue Procedures in the Long-term Management of Patients with Syndromic Craniosynostosis
Tayla Moshal, BS; Idean Roohani, BS; Marah I Jolibois, MS; Sasha Lasky, BS; Eloise Stanton, BS; Erin M Wolfe, MD; Naikhoba CO Munabi, MD, MPH; Jeffrey A Hammoudeh, MD, DDS; Mark M Urata, MD, DDS
Background
●Skeletal craniofacial operations to treat different syndromic craniosynostoses are frequently discussed in the literature.
●However, soft-tissue procedures required to normalize facial appearance along these patients’ care timelines are less well described.
●This study evaluated and compared the secondary soft tissue surgeries necessary for patients with various craniosynostosis syndromes.
Methods
●Retrospective review of patients with syndromic craniosynostosis treated at a tertiary children’s hospital from 2004–2023.
●Soft tissue surgeries included:
- Lateral and medial canthopexy
- Ptosis reconstruction
- Eyebrow elevation
- Septorhinoplasty
- Otoplasty
- Scar revision
- Scalp reconstruction
- Fat Grafting
●Statistics:
●Descriptive statistics, chi-squared, and independent t-tests analyzed differences in soft tissue procedures between craniofacial syndromes
Results
●n=103 (Figure 1; Syndromic Diagnoses)
●Mean follow-up: 7.7±5.7 years
●93 patients (90.3%) underwent ≥1 soft tissue procedure (mean = 3.6±3.3)
●Significant differences in rates of:
Brow elevation: Saethre-Chotzen (63.6%) > Crouzon (25.8.%, p=0.034).
Scalp reconstruction: Pfeiffer (50.0%) > Apert (32.5%, p=0.039), Crouzon (22.6%, p=0.007), and Muenke (0.0%, p=0.015).
Septorhinoplasty: Crouzon (29.0%) > Apert (0.0%, p<0.001) and Saethre-Chotzen (0.0%, p=0.044).
●No differences in other soft tissue procedures
●Figure 2 displays soft tissue procedures timelines
Conclusion
●Soft tissue procedures were very common among patients with syndromic craniosynostosis.
●Rates of brow elevation, scalp reconstruction, and septorhinoplasty varied significantly by syndrome.
●These results may help surgeons counsel patients on anticipated surgical procedures necessary for comprehensive craniofacial reconstruction.
●Continued research is encouraged, and treatment should remain tailored to each patient’s reconstructive needs.
