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Craniotomy of the Fused Sagittal Suture Over the Superior Sagittal Sinus Is a Safe Procedure

Kölby, David BSc; Fischer, Sara MD; Arab, Khalid MD; Maltese, Giovanni MD, PhD; Olsson, Robert MD; Paganini, Anna MSc; Tarnow, Peter MD, PhD; Kölby, Lars MD, PhD

Journal of Craniofacial Surgery: May 2017 - Volume 28 - Issue 3 - p 650–653
doi: 10.1097/SCS.0000000000003440
Original Articles

Introduction: Spring-assisted cranioplasty to correct sagittal synostosis is based on midline craniotomy through the closed sagittal suture, over the superior sagittal sinus (SSS). The aim of the present study was to evaluate the perioperative safety of this technique.

Materials and Methods: This is a retrospective study of all patients operated with median craniotomy and springs from 1998 to the end of 2015. For comparison, all Pi-plasties performed during the same time interval were also evaluated. The safety measures were evaluated based on incidence of damage to SSS, incidence of dural tears, perioperative blood loss, operative time, and hospital stay.

Results: In the group that had undergone midline craniotomy combined with springs (n = 225), 4 perioperative damages to SSS and 1 dural tear were seen. The perioperative blood loss was 62.8 ± 65.3 mL (mean ± standard deviation). The operative time was 67.9 ± 21.5 minutes and the hospital stay was 4.8 ± 1.1 days. In the group that had undergone pi-plasty (n = 105), no damages to SSS but 3 dural tears were seen. The perioperative blood loss was 352.8 ± 174.4 mL. The operative time was 126.0 ± 31.7 minutes and the hospital stay was 7.1 ± 1.4 days.

Conclusion: Craniotomy SSS in sagittal synostosis is a safe procedure with low morbidity in terms of damage to the SSS. Midline craniotomy combined with springs has significantly lower preoperative blood loss, operative time, and hospital stay (P < 0.001 for all) compared to pi-plasty.

Department of Plastic Surgery, Sahlgrenska University Hospital, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Address correspondence and reprint requests to Lars Kölby, MD, PhD, Institute for Clinical Sciences, Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg University, SE-413 45 Gothenburg, Sweden; E-mail: lars.kolby@surgery.gu.se

Received 8 September, 2016

Accepted 2 November, 2016

The study was conducted according to the principles stated in the Declaration of Helsinki, and it was approved by the Gothenburg Ethics Committee (journal no 784-11).

This work was supported by the Ester Åsberg-Lindberg Fund, the Centre for Clinical Research in Falun, the Wilhelm and Martina Lundgren Science Research Fund, the Anna and Edwin Berger Foundation, the Gothenburg Medical Society, and the H.M. Queen Silvia Jubilee Foundation.

The authors report no conflicts of interest.

© 2017 by Mutaz B. Habal, MD.