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fitmomof2ae
10-28-2009, 08:44 PM
Classification System for Sagittal Craniosynostosis

David, Lisa MD; Glazier, Steven MD; Pyle, Jeremy MD; Thompson, James MD; Argenta, Louis MD





http://journals.lww.com/_layouts/1033/IMAGES/OAKS.Journals/icon-minus.gif (http://javascript<b></b>:showHide('ej-article-box-text1', 'img1')) Abstract



Scaphocephaly is an important but incompletely defined entity resulting from premature fusion of the sagittal suture. Our goal was to use the clarity afforded by three-dimensional computed tomographies (CTs) to discern what characteristics of this disease are most representative and singular. Furthermore, we sought to define a classification system wherein the dominant physical trait, as it results from varied sites of premature fusion, determines the type of scaphocephaly in a particular patient. All patients with CT-diagnosed isolated single-suture sagittal craniosynostosis seen by a single craniofacial surgeon and a single pediatric neurosurgeon over a 5-year period are included (N = 76). Patients were stratified into anterior, central, posterior, or complex subtypes dependent upon the presence of a single dominant characteristic as seen on CT scan. Anterior type features a transverse retrocoronal band; central type has a heaped sagittal ridge; posterior type has an especially prominent occiput; and complex type includes those patients in whom a single dominant feature is not present. Forty-eight patients fit into anterior, central, or posterior types. Thirteen percent (N = 7) lack a single dominant feature and are complex. Incidence and prevalence for each type in this population are the following: anterior, 13/24%; central, 16/29%; posterior, 19/35%; and complex, 7/13%. Heterogeneous points of initial fusion may be responsible for the differing representations. Clinical applications using this classification system are ongoing and may allow us to individualize surgical intervention to optimize clinical outcome.


It would be nice to know which type of surgery will be most optimal for our children. Then, we as parents, wouldn't have to make that decision and wonder if we made the right decision. Also, maybe they will find that the posterior cvr is not the best surgery for some sagittals (depending on the classification status) because it might cause a "bump". Just a thought.

How would you classify your sagittal?

Sophia's_mom
10-28-2009, 09:14 PM
I'm not sure I totally understand the wording and I'm going to have to google some of it like "transverse retrocoronal band" for anterior and "heaped sagittal ridge" for central. I get "prominent occiput" for posterior, that would be the bossing in the back right? I think Sophie probably fell into the complex group as her head was very long and narrow with extreme bossing in both the front and the back. I'll do some googling and see if my opinion changes. I think it's amazing they are doing this study so in the future hopefully there won't be so much guessing as to what is the best surgery option.