Cognitive Outcomes of Children With Sagittal Craniosynostosis Treated With Either Endoscopic or Open Calvarial Vault Surgery.

Importance: Several studies have reported a higher incidence of neurodevelopmental delays and cognitive deficits in patients with single-suture craniosynostosis; however, there are few studies examining the associations of repair type with cognitive outcomes.

Objective: To measure differences in neuropsychological outcomes between school-age children who were treated for sagittal craniosynostosis and unaffected controls and explore differences in cognitive function among children with sagittal craniosynostosis who were previously treated with either endoscopic strip craniectomy or open calvarial vault surgery.

Design, Setting, And Participants: This cohort study was performed between 2018 and 2022.

Impact of Neighborhood Deprivation and Social Vulnerability on Outcomes and Interventions in Patients with Cleft Palate.

Objective: To examine whether neighborhood disadvantage impacts length of follow-up, interventions, and outcomes for patients with cleft palate.

Design: Retrospective cohort.

Setting: Cleft Palate Craniofacial Institute Database at St.

Helmet Therapy for the Management of Deformational Plagiocephaly in Pediatric Patients with Shunted Hydrocephalus.

Objective: To evaluate the safety and efficacy of helmet therapy for deformational plagiocephaly in patients with shunted hydrocephalus.

Design: Retrospective chart review.

Setting: Institutional, tertiary-care hospital.

Multidisciplinary Optimal Outcomes Reporting and Team Clinic Retention in Isolated Nonsyndromic Cleft Palate.

Objective: Optimal Outcomes Reporting was recently introduced to categorize outcomes after cleft palate repair. We seek to propose an expanded version of Optimal Outcomes Reporting and to determine if correlation exists between the expanded outcomes and persistence with team care follow-up through age 9.

Design: Retrospective cohort study.

Family Experiences with Diagnosis of Craniosynostosis: Thematic Analysis of Online Discussion Boards.

Objective: Apply thematic analysis of online discussion boards to characterize families' experiences and concerns regarding craniosynostosis diagnoses to aid physicians in tailoring care to families.

Design: Grounded theory-based qualitative analysis.

Setting: Discussion boards related to craniosynostosis identified via Google and Yahoo.

School-age anthropometric and patient-reported outcomes after open or endoscopic repair of sagittal craniosynostosis.

Objective: Several studies have compared perioperative parameters and early postoperative morphology between endoscope-assisted strip craniectomy with orthotic therapy (endoscopic repair) and cranial vault remodeling (open repair). To extend these results, the authors evaluated school-age anthropometric outcomes after these techniques across three institutions.

Methods: School-aged children (age range 4-18 years) with previously corrected isolated sagittal craniosynostosis were enrolled.

Impact of neighborhood deprivation and social vulnerability on long-term outcomes and desire for revision in patients with craniosynostosis.

Objective: The authors utilized the area deprivation index (ADI), a validated composite measure of socioeconomic disadvantage, and the social vulnerability index (SVI) to examine whether differences in neighborhood deprivation impact interventions and outcomes among patients with craniosynostosis.

Methods: Patients who underwent craniosynostosis repair between 2012 and 2017 were included. The authors collected data about demographic characteristics, comorbidities, follow-up visits, interventions, complications, desire for revision, and speech, developmental, and behavioral outcomes.

Calvarial Vault Remodeling Technique for Lambdoid Craniosynostosis.

Premature fusion of the lambdoid suture is the most uncommon single-suture synostosis. It presents with a classic "windswept" appearance, a trapezoid-shaped head, and significant skull asymmetry notable for an ipsilateral mastoid bulge and contralateral frontal bossing. Because of the rarity of lambdoid synostosis, little is known about optimal techniques for its treatment.

Outcomes after Endoscope-Assisted Strip Craniectomy and Orthotic Therapy for Syndromic Craniosynostosis.

Background: Endoscopic craniosynostosis repair has emerged as an effective alternative to open repair, but data are limited on treatment of the 15% to 24% of patients with syndromic diagnoses. In this study, the authors examine postoperative outcomes after endoscopic repair in syndromic craniosynostosis.

Methods: Retrospective review was performed of all consecutive patients undergoing endoscopic repair and all syndromic patients undergoing open repair from 2006 to 2021.

Impact of age at endoscopic metopic synostosis repair on anthropometric outcomes.

Objective: Endoscopic strip craniectomy for metopic craniosynostosis relies on rapid growth and postoperative helmeting for correction. Endoscopic repair is generally performed before patients reach 4 months of age, and outcomes in older patients have yet to be quantified. Here, the authors examined a cohort of patients treated with endoscopic repair before or after 4 months of age to determine aesthetic outcomes of delayed repairs.

Neurodevelopment in unilateral coronal craniosynostosis: a systematic review and meta-analysis.

Objective: The current literature on unilateral coronal craniosynostosis is replete with repair techniques and surgical outcomes; however, information regarding neurodevelopment remains unclear. Therefore, the aim of this systematic review and meta-analysis was to comprehensively assess the neurodevelopmental outcomes of patients with unicoronal craniosynostosis compared with their healthy peers or normative data.

Methods: A systematic review of the Ovid MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ClinicalTrials.

Cognitive Development in Lambdoid Craniosynostosis: A Systematic Review and Meta-Analysis.

Objective: Lambdoid craniosynostosis affects approximately 1 in 33 000 live births per year, and surgical correction is often sought in order to achieve normocephaly and allow for adequate brain growth. However, the effects of lambdoid synostosis and its treatment on cognitive development are unknown.

Design: Systematic review and meta-analysis.

Shared Decision-Making: Process for Design and Implementation of a Decision Aid for Patients With Craniosynostosis.

To describe the process of developing a craniosynostosis decision aid. We conducted a mixed-methods exploratory study between August 2019 and March 2020 to develop a decision aid about surgical treatment for single suture craniosynostosis. A single tertiary care academic children's hospital.

A multi-institutional survey on calvarial vault remodeling techniques for sagittal synostosis and outcomes analysis for patients treated at 12 months and older.

Objective: Surgical treatment of sagittal craniosynostosis is challenging in older patients. This study aimed to assess the effect of increasing age on open surgical technique selection and patient outcomes using the multi-institutional Synostosis Research Group (SynRG) collaboration.

Methods: Surgeons in SynRG were surveyed for key influences on their preferred open calvarial vault remodeling techniques at various patient ages: < 6, 6-12, and > 12 months.

Impact of a Palatal Fistula After Cleft Palate Repair on Velopharyngeal Closure.

Purpose: A palatal fistula is an adverse outcome of cleft palate repair. It is unknown if a palatal fistula will influence velopharyngeal closure, even after repair of the fistula. This study determines the effect of a soft palate fistula on the risk of developing velopharyngeal insufficiency.

Factors contributing to delay or absence of alveolar bone grafting.

Introduction: Alveolar bone grafting (ABG) delay can lead to suboptimal outcomes. This study seeks to categorize reasons patients with cleft lip and palate have no record of ABG or who underwent later than typical ABG (≥13 years).

Methods: At a single tertiary care center, a retrospective review was performed of all patients with unilateral, complete cleft lip and palate, born 1998-2005.

School-age outcomes in patients with unilateral coronal synostosis: comparison of fronto-orbital advancement and endoscopic strip craniectomy.

Objective: Outcomes research on unilateral coronal synostosis is mostly limited to the early postoperative period. This study examines facial asymmetry, desire for revision, and patient-reported outcomes at school age in children who received either endoscopic strip craniectomy with helmet therapy or fronto-orbital advancement (open repair).

Methods: Patients with repaired unilateral coronal synostosis born between 2000 and 2017, with 3D photographs taken when they were between 3.

Using Patient-Reported Outcome Measures to Screen for Cognitive Function Deficits and Stigma in Patients with Single-Suture Craniosynostosis.

Summary: Children with single-suture craniosynostosis have small but significant deficits in appearance ratings and neurodevelopment. Traditionally, these parameters are studied using a full battery of examinations, which are very time consuming. This study evaluated a convenient method to measure psychosocial parameters in this population by utilizing patient-reported outcomes measures to evaluate cognitive function and stigma.

Cost of Cleft Team Care at an Academic Children's Hospital.

Background: The financial burden of cleft-craniofacial team care is substantial, and high costs can hinder successful completion of team care.

Solution: Collaboration with multiple stakeholders including providers, insurers, and patient guardians, as well as hospital administrators, is critical to increase patient retention and improve final clinical outcomes.

What We Do That Is New: At our cleft and craniofacial center, charges for a team care visit fall into one of three categories-hospital fees, professional fees, or external fees.

Long-Term Effects of Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate: A Systematic Review and Meta-Analysis.

Objective: The aim of this systematic review and meta-analysis was to investigate long-term treatment effects of nasoalveolar molding (NAM) in patients with unilateral cleft lip and palate (UCLP).

Design: Included manuscripts met the following criteria: (1) involved patients with UCLP who received NAM; (2) included comparison group(s) who either received non-NAM passive presurgical infant orthopedic appliances (PSIO) or who did not receive any PSIO; (3) reported at least one objective or validated measure of nasolabial, craniofacial, or palatal form; and (4) had patient follow-up beyond 4 years of age.

Results: A total of 12 studies were included in this review.

Effects of Single-Dose Preoperative Pregabalin on Postoperative Pain and Opioid Consumption in Cleft Orthognathic Surgery.

Background: Several studies have illustrated the efficacy of pregabalin in decreasing postoperative opioid use in adults undergoing orthognathic surgery. We aimed to study the effects of a single dose of preoperative pregabalin on total opioid consumption after orthognathic surgery in individuals with cleft lip and palate.

Methods: This is a retrospective cohort study of consecutive patients who underwent Le Fort I midface advancement between June 2012 and July 2019.

Presurgical Orthopedic Intervention Prior to Cleft Lip and Palate Repair: Nasoalveolar Molding Versus Passive Molding Appliance Therapy.

Background: Nasoalveolar molding (NAM) is a widely used presurgical orthopedic device, despite disputes over its effectiveness. This study compares the outcomes after cleft lip and nose repair in patients who received NAM versus those who underwent passive alveolar molding with lip taping.

Methods: A retrospective review of patients with complete unilateral cleft lip and palate who received either NAM (n = 16) or passive molding (n = 10) treatments was conducted.

Evaluation of Discipline-Specific Outcomes Through a Multidisciplinary Team Clinic for Patients With Isolated Cleft Palate.

Objective: To describe the incidence and timing of provider-specific interventions for children with isolated cleft palate.

Design: This was a retrospective cohort study involving review of medical records.

Setting: Multidisciplinary team care clinic at a tertiary academic children's hospital between January 2000 and July 2019.

Morphologic Severity of Craniosynostosis: Implications for Speech and Neurodevelopment.

Background: Single-suture craniosynostosis (SSC) can be associated with neurodevelopmental deficits. We examined the correlation between morphologic severity and incidence of speech-language or psychological concerns.

Methods: In 62 patients (33 sagittal, 17 metopic, and 12 unicoronal), morphologic severity was determined via preoperative computed tomography (CT).

Using an Intake Form and Clinic Dashboard to Tailor and Improve the Cleft Team Clinic Visit for Families.

Background: Multidisciplinary cleft care protocols commonly do not incorporate family needs, concerns, and preferences.

Solution: A family-centered model would incorporate family needs, concerns, and preferences with a view toward lessening burden of care while achieving outcomes important to families.

What We Do: Our Intake Form helps us adapt visits to better meet families' needs, and our Dashboard enables Team Coordinators to direct efficient patient flows, lessening wait times and care burden.