Lambdoid Craniosynostosis: The Relationship with Chiari Deformations and an Analysis of Surgical Outcomes.

Background: A relationship between lambdoid craniosynostosis and Chiari deformations has been suggested, but the true extent of this association remains uncertain. The authors reviewed a single center's experience treating lambdoid synostosis to further elucidate this relationship, examine surgical outcomes, and identify associations that might impact future treatments.

Methods: A retrospective chart review was performed of all patients treated for lambdoid craniosynostosis, excluding the syndromic craniosynostoses.

Adopted children with cleft lip and/or palate: a unique and growing population.

Background: Standard clinical pathways are well established for children with cleft lip and/or palate. Treatment of internationally adopted children differs because of the late age at presentation, a newly evolving child-family relationship, and variable extent and quality of previous treatment.

Methods: The authors characterized the presentation and treatment patterns of all internationally adopted children with clefts at their institution between 1997 and 2011.

Evidence-based medicine: Craniosynostosis.

Learning Objectives: After studying this article, the participant should be able to: (1) Make the appropriate diagnosis for each of the single-sutural synostoses, based on the physical examination. (2) Explain the functional concerns associated with these synostoses and why surgical correction is indicated. (3) Distinguish between the different types of surgical corrections available, the timing for these various interventions, and in what ways these treatments achieve overall management objectives.

Effects of hypotensive anesthesia on blood transfusion rates in craniosynostosis corrections.

Background: Hypotensive anesthesia is routinely used during craniosynostosis corrections to reduce blood loss. Noting that cerebral oxygenation levels often fell below recommended levels, the authors sought to measure the effects of hypotensive versus standard anesthesia on blood transfusion rates.

Methods: One hundred children undergoing craniosynostosis corrections were randomized prospectively into two groups: a target mean arterial pressure of either 50 mm Hg or 60 mm Hg.

Apert syndrome: evaluation of a treatment algorithm.

Background: The authors catalogued phenotypic variability among children with Apert syndrome, reviewed surgical outcomes (particularly with respect to their treatment goals of avoiding preventable developmental delays and reducing operative interventions), and examined correlations that might stimulate improved treatment paradigms.

Methods: A case series review of all Apert syndrome patients, treated by a single surgeon, including phenotypic variations, mutational analyses, developmental assessments, and surgical treatments, was performed.

Results: Over a 20-year period, 135 Apert syndrome patients were treated (32 percent from birth).

Dynamic abdominoplasty for the treatment of prune belly syndrome.

Background: The deficient abdominal wall musculature associated with prune belly syndrome often results in numerous functional disabilities, including diminished cough, impaired bladder and bowel function, and poor posture and balance. Traditional abdominoplasties focus on static fascial excisions or plications. The authors sought to assess their preliminary experience with a new abdominoplasty technique that incorporates standard fascial tightening with bilateral pedicled rectus femoris muscle transfers.

Limited reduction cranioplasty for the treatment of hydrocephalic macrocephaly.

Background: Hydrocephalic macrocephaly, occurring despite adequate cerebrospinal fluid shunting, is rare, and most publications advocate near-total cranial vault reduction procedures. The authors reviewed our series of limited reductions (designed to minimize complications while still providing functional benefits) to evaluate outcomes.

Methods: All patients undergoing posterior reduction cranioplasties were retrospectively reviewed for outcomes, including operative data, length of stay, preoperative and postoperative anthropometrics, and complications.