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Todd C. Hankinson, Elizabeth J. Fontana, Richard C. E. Anderson and Neil A. Feldstein

Dis Child 90 : 346 – 350 , 2005 11 Bottero L , Lajeunie E , Arnaud E , Marchac D , Renier D : Functional outcome after surgery for trigonocephaly . Plast Reconstr Surg 102 : 952 – 960 , 1998 12 Bristol RE , Lekovic GP , Rekate HL : The effects of craniosynostosis on the brain with respect to intracranial pressure . Semin Pediatr Neurol 11 : 262 – 267 , 2004 13 Cohen SR , Persing JA : Intracranial pressure in single-suture craniosynostosis . Cleft Palate Craniofac J 35 : 194 – 196 , 1998 14 Da Costa AC , Walters

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Ralph B. Cloward

Since the early days of Harvey Cushing, neurosurgeons have been taught to close the scalp with a double layer of sutures. The interrupted layer of buried sutures, usually of silk, has always been considered a necessity for the proper closure of the scalp, to arrest bleeding in the deep layers of this highly vascular skin and prevent subcutaneous hemorrhage which may delay healing. In the interest of shortening operative time surgeons recently have advocated single-suture technique for closure of the scalp. The interrupted over-and-over suture with stainless

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Justin S. Cetas, Morad Nasseri, Targol Saedi, Anna A. Kuang and Nathan R. Selden

, early detection and timely treatment of delayed intracranial hypertension after cranial vault reconstruction is necessary to avoid permanent visual and/or neurocognitive deficits. The primary rationale for annual postoperative clinical and ophthalmological surveillance of patients with cranial synostosis is to promote early detection. 3 In this paper we report on a consecutive series of 156 children who underwent cranial vault reconstruction for nonsyndromic single-suture cranial synostosis at a single tertiary care pediatric hospital. Eighty-one patients with at

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Alaina Whitton, Sharon L. Hyzy, Chelsea Britt, Joseph K. Williams, Barbara D. Boyan and Rene Olivares-Navarrete

pressure, vision loss, and mental retardation. 16 , 17 , 38 , 39 These effects can be mitigated, and acceptable cosmetic outcomes obtained, if surgical intervention occurs early; however, there is a risk that the bone will fuse again prematurely. Craniosynostosis can be classified by the number of sutures involved (single or multiple) and by the location of the sutures (metopic, coronal, sagittal, and lambdoid). Craniosynostosis that occurs as an isolated event where no gene defect has been identified (“nonsyndromic”) usually affects a single suture. Alternatively

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Han Yan, Taylor J. Abel, Naif M. Alotaibi, Melanie Anderson, Toba N. Niazi, Alexander G. Weil, Aria Fallah, John H. Phillips, Christopher R. Forrest, Abhaya V. Kulkarni, James M. Drake and George M. Ibrahim

A lthough emerging data from the endoscopic treatment of sagittal synostosis suggest more favorable perioperative outcomes, there is substantially less data to inform decisions for the surgical treatment of nonsagittal single-suture craniosynostosis. Metopic craniosynostosis, or trigonocephaly, is often characterized by a triangular anterior cranial vault, bitemporal narrowing with biparietal expansion, or midline forehead ridging. The incidence of metopic synostosis has been estimated to be as high as 1 in 5000 births, 23 and accounts for 10% of all

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Kathleen A. Kapp-Simon, Erin Wallace, Brent R. Collett, Mary Michaeleen Cradock, Canice E. Crerand and Matthew L. Speltz

P remature fusion of one of the major cranial sutures (sagittal, metopic, coronal, or lambdoid), known as single-suture craniosynostosis (SSC), occurs in approximately 1 in 1700 to 1 in 2500 live births. 17 , 42 Studies of infants with SSC have shown that affected children demonstrate modest delays in motor and cognitive development relative to test norms. 22 , 24 In the largest infant study to date, we followed children with and without SSC from infancy to age 3 years and found that children with SSC scored from 0.25 to 0.50 standard deviations lower

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Jacqueline R. Starr, Kathleen A. Kapp-Simon, Yona Keich Cloonan, Brent R. Collett, Mary Michaeleen Cradock, Lauren Buono, Michael L. Cunningham and Matthew L. Speltz

. Single-suture craniosynostosis has been associated with cognitive and motor delays during infancy as well as an elevated risk of learning and language disabilities in school-age children and adolescents. 14 , 22 Despite the rationale for intracranial surgery in infants, we still lack a definitive understanding of the association between SSC and neurodevelopment. In addition to a need for larger study samples and more sensitive measures of neurodevelopment, one factor limiting the current understanding of the implications of SSC for neurodevelopment is the

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Kristina Aldridge, Brent R. Collett, Erin R. Wallace, Craig Birgfeld, Jordan R. Austin, Regina Yeh, Madison Feil, Kathleen A. Kapp-Simon, Elizabeth H. Aylward, Michael L. Cunningham and Matthew L. Speltz

S ingle - suture craniosynostosis (SSC) is defined by the premature fusion of one of the cranial sutures, including the sagittal, metopic, right or left coronal, or right or left lambdoid. Across all sutures, SSC occurs in roughly 1 in 2000 live births. 18 , 36 The diagnostic phenotype of SSC is characterized by dysmorphology of the craniofacial skeleton, confirmed by radiographic evidence of a closed suture. The idea that single-suture fusions might compromise neurodevelopment has been discussed for many years. Numerous studies of children with SSC both

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David F. Jimenez, Michael J. McGinity and Constance M. Barone

defined as a ratio less than 40 and hypertelorism as a ratio greater than 55. Study Population Between 1998 and 2017, a total of 141 consecutive patients with metopic single-suture nonsyndromic craniosynostosis were treated with endoscopy-assisted craniectomy of the involved metopic suture. One hundred seven patients were male (75.9%) and 34 (24.1%) were female. The mean age at time of surgery was 4.1 months (median 3.9 months, range 0.82–12.64 months). The mean weight of the patients was 6.4 kg (median 6.5 kg, range 3.5–10.7 kg). The only preoperative serum value

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Daniela Chieffo, Gianpiero Tamburrini, Luca Massimi, Simona Di Giovanni, Cristina Giansanti, Massimo Caldarelli and Concezio Di Rocco

defects were found in 2 (7%) of 30 cases. Rapidity and comprehension reading skills were defective in 2 (7%) of 30 cases, whereas 1 patient (3%) had scores below the normal range in the writing competency tests. Discussion Single-suture craniosynostoses are not commonly associated with developmental disorders. Minor developmental delays and minor learning disabilities have been reported occasionally; however, their pathogenesis is still a matter of debate. 11 , 13 According to Arnaud et al., 3 minor developmental defects may be the consequence of increased