Bone thickness and other variables that can predict outcomes in individuals with craniosynostosis are critical for surgical decision-making, but they are still poorly understood. Recent investigations have proven surgical procedures’ relative risks and advantages for restoring head shape in patients with nonsyndromic sagittal craniosynostosis. This study determined the link between parietal bone thickness and perioperative outcomes in individuals with nonsyndromic sagittal craniosynostosis treated with spring-mediated cranioplasty (SMC). Between 2011 and 2021, patients who had a craniectomy and SMC for nonsyndromic sagittal craniosynostosis at a quaternary pediatric hospital were included. The thickness of the anterior parietal, mid parietal, and posterior parietal bones were measured by Researchers on preoperative CT at 27 suture-related points: at the suture line and 0.5 cm, 1.0 cm, 1.5 cm, and 2.0 cm from the suture at the anterior, mid parietal, and posterior parietal bones. Preoperative skull thickness was linked to intraoperative blood loss, transfusion demand, and length of stay in the hospital (LOS).

In total, 124 patients were included in this study, with a mean age at surgery of (3.59±0.87) months and a mean parietal bone thickness of 1.83±0.38 mm. Estimated blood loss (EBL) and EBL per kilogramme were linked to parietal bone thickness at 0.5 cm (P=0.376, P< 0.001 and=0.331,P=0.004; respectively) and 1.0 cm (P=0.324, P=0.007 and P=0.245, P=0.033; respectively). When adjusted for age, sex, and race, patients with a thicker parietal bone 0.5 cm (OR 18.08, P=0.007), 1.0 cm (OR 7.16, P=0.031), and 1.5 cm (OR 7.24, P=0.046) from the suture line were considerably more likely to have received a transfusion. Perioperative outcomes such as transfusion, EBL, and LOS may be predicted by parietal bone thickness rather than age at the time of surgery. The need for transfusion and EBL was greatest for parietal bone thickness between 0.5 and 1.5 cm from the suture line within the tubectomy area. For patients undergoing craniofacial surgery, the parietal bone thickness can help predict the requirement for intraoperative transfusions and length of stay in the hospital.

 

Reference:thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/aop/article-10.3171-2021.12.PEDS21541/article-10.3171-2021.12.PEDS21541.xml