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Effect of Presurgical Positioning on Skull Shape in Sagittal Suture Synostosis

van Veelen, Marie-Lise C. MD*; Bredero, Hansje H. MANP; Dirven, Clemens M.F. MD, PhD*; Mathijssen, Irene M.J. MD, PhD

doi: 10.1097/SCS.0000000000002021
Brief Clinical Studies
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Purpose: The aim of the this study was to describe changes in head circumference (HC) and cephalic index (CI) in children with sagittal suture synostosis before surgery, by putting the child to bed in supine position lying on the back of the head.

Materials and Methods: A total of 83 patients were scheduled for minimally invasive spring-assisted correction at age 5 to 6 months. At presentation, parents were advised to place their child in bed lying on the back of their head. Preoperative evaluation involved measurement of HC and CI. Head circumference was measured at 2 time points in 33 patients and the CI at 2 time points in 19 patients.

Results: Head circumference (in SD) decreased from 1.69 to 1.37 and the CI increased from 66 to 69.

Conclusion: Before surgery, positioning patients with sagittal suture synostosis on the back of the head is a feasible and effective way of changing head shape. More research is needed to evaluate the postsurgical effects on the long term.

*Erasmus University Medical Center Rotterdam, Department of Neurosurgery

Erasmus University Medical Center Rotterdam, Department of Plastic and Reconstructive Surgery and Hand Surgery, Rotterdam, The Netherlands.

Address correspondence and reprint requests to Marie-Lise C. van Veelen, MD, Erasmus University Medical Center Rotterdam, Department of Neurosurgery, PO Box 2060, 3000 CB Rotterdam, The Netherlands; E-mail: m.l.c.vanveelen@erasmusmc.nl

Received 7 October, 2014

Accepted 28 June, 2015

The authors report no conflicts of interest.

Clinical trial registration: This study was not subject to the Medical Research Involving Human Subjects Act (WMO), as this study does not involve any form of invasion of the study participant's integrity.

© 2015 by Mutaz B. Habal, MD.