Single-suture craniosynostosis and the epigenome: current evidence and a review of epigenetic principles
Neurosurg Focus. 2021 Apr;50(4):E10. doi: 10.3171/2021.1.FOCUS201008.ABSTRACTCraniosynostosis (CS) is a congenital disease that arises due to premature ossification of single or multiple sutures, which results in skull deformities. The surgical management of single-suture CS continues to evolve and is driven by a robust body of clinical research; however, the molecular underpinnings of CS remain poorly understood. Despite long-standing hypotheses regarding the interaction of genetic predisposition and environmental factors, formal investigation of the epigenetic underpinnings of CS has been limited. In an effort to catalyz...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Othman Bin Alamer Adrian E Jimenez Tej D Azad Source Type: research

Introduction. Controversies in the management of single-suture craniosynostosis
Neurosurg Focus. 2021 Apr;50(4):E1. doi: 10.3171/2021.1.FOCUS2130.NO ABSTRACTPMID:33794486 | DOI:10.3171/2021.1.FOCUS2130 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Concezio Di Rocco John R W Kestle Richard Hayward Jesse A Taylor Source Type: research

Hydrocephalus treatment in patients with craniosynostosis: an analysis from the Hydrocephalus Clinical Research Network prospective registry
CONCLUSIONS: This is the largest prospective study reported on children with craniosynostosis and hydrocephalus. Hydrocephalus in children with craniosynostosis most commonly occurs in syndromic patients and multisuture fusion. It is treated at varying ages; however, most patients undergo surgery for craniosynostosis prior to hydrocephalus treatment. While VPS treatment is performed more frequently, VPS and ETV are both reasonable options, with decreasing revision rates with increasing age, for the treatment of hydrocephalus associated with craniosynostosis.PMID:33794488 | DOI:10.3171/2021.1.FOCUS20979 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Christopher M Bonfield Chevis N Shannon Ron W Reeder Samuel Browd James Drake Jason S Hauptman Abhaya V Kulkarni David D Limbrick Patrick J McDonald Robert Naftel Ian F Pollack Jay Riva-Cambrin Curtis Rozzelle Mandeep S Tamber William E Whitehead John R W Source Type: research

Disappointing results of spring-assisted cranial vault expansion in patients with Crouzon syndrome presenting with sagittal synostosis
Neurosurg Focus. 2021 Apr;50(4):E12. doi: 10.3171/2021.1.FOCUS20739.ABSTRACTThe aim of this study was to report on a single center's experience with spring-assisted cranial vault expansion (SAE) in patients with Crouzon syndrome and sagittal suture synostosis. Strip craniotomy with SAE has resulted in successful outcomes with low complication and revision rates in patients with isolated scaphocephaly. However, recent experience suggests that outcomes in patients with Crouzon syndrome and sagittal synostosis (SS) who undergo SAE are less favorable compared with the outcomes of those who undergo frontobiparietal (FBP) expans...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Alexander T Wilson Linda Gaillard Sarah L Versnel Jochem K H Spoor Marie-Lise C van Veelen Irene M J Mathijssen Source Type: research

Improved cephalic index following early cranial vault remodeling in patients with isolated nonsyndromic sagittal synostosis
This study aimed to evaluate the authors' institutional experience of surgically treating SS using a modified subtotal cranial vault remodeling technique in a population-based cohort. Special attention was directed toward the effect of patient age at time of surgery on long-term CI outcome.METHODS: A retrospective analysis was conducted on all patients with isolated nonsyndromic SS who were surgically treated from 2003 to 2011. Data from electronic medical records were gathered. Eighty-two patients with SS were identified, 77 fulfilled inclusion criteria, and 72 had sufficient follow-up data and were included. CI during fo...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Arvid Frostell Maryam Haghighi Jiri Bartek Ulrika Sandvik Bengt Gustavsson Adrian Elmi-Terander Erik Edstr öm Source Type: research

Editorial. Is the helmet doing most of the job in the endoscopic correction of craniosynostosis?
Neurosurg Focus. 2021 Apr;50(4):E9. doi: 10.3171/2021.1.FOCUS2125.NO ABSTRACTPMID:33794491 | DOI:10.3171/2021.1.FOCUS2125 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Concezio Di Rocco Source Type: research

Ultra-early synostectomy and cranial remodeling orthoses in the management of craniosynostoses
CONCLUSIONS: The data show that ultra-early synostectomy is safe and not associated with increased complications compared with surgery performed between 3 and 6 months of age. Infants with multisuture synostosis had increased operative time, required blood transfusion, and were more likely to require a second operation.PMID:33794492 | DOI:10.3171/2021.1.FOCUS201014 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Aaron Mohanty Thomas S Frank Sharif Mohamed Kristalynne Godwin Gautam G Malkani Source Type: research

Impact of health disparities on treatment for single-suture craniosynostosis in an era of multimodal care
In this study, the authors aimed to evaluate the impact of race/ethnicity and insurance status on age of presentation/surgery in children with craniosynostosis to highlight potential disparities in healthcare access. Charts were reviewed for children with craniosynostosis at two tertiary care hospitals in New York City from January 1, 2014, to August 31, 2020. Clinical and demographic data were collected, including variables pertaining to family socioeconomic status, home address/zip code, insurance status (no insurance, Medicaid, or private), race/ethnicity, age and date of presentation for initial consultation, type of s...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Caitlin Hoffman Alyssa B Valenti Eseosa Odigie Kwanza Warren Ishani D Premaratne Thomas A Imahiyerobo Source Type: research

Editorial. Disparities in access to healthcare and the neurosurgeon
Neurosurg Focus. 2021 Apr;50(4):E14. doi: 10.3171/2021.1.FOCUS2124.NO ABSTRACTPMID:33794494 | DOI:10.3171/2021.1.FOCUS2124 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Richard Hayward Source Type: research

Sport participation and related head injuries following craniosynostosis correction: a survey study
The objective of this survey study was to describe sport participation and sport-related head injury in CS patients.METHODS: A 16-question survey related to child/parent demographics, CS surgery history, sport history, and sport-induced head injury history was made available to patients/parents in the United States through a series of synostosis organization listservs, as well as synostosis-focused Facebook groups, between October 2019 and June 2020. Sports were categorized based on the American Academy of Pediatrics groupings. Pearson's chi-square test, Fisher's exact test, and the independent-samples t-test were used in ...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Aaron M Yengo-Kahn Oluwatoyin Akinnusotu Alyssa L Wiseman Muhammad Owais Abdul Ghani Chevis N Shannon Michael S Golinko Christopher M Bonfield Source Type: research

Erratum. Biographies of international women leaders in neurosurgery
Neurosurg Focus. 2021 Apr;50(4):E16. doi: 10.3171/2021.3.FOCUS201096a.NO ABSTRACTPMID:33794496 | DOI:10.3171/2021.3.FOCUS201096a (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Katherine M Berry Source Type: research

Quantitative and qualitative comparison of morphometric outcomes after endoscopic and conventional correction of sagittal and metopic craniosynostosis versus control groups
CONCLUSIONS: This quantitative analysis confirms that the performed surgical techniques of endoscopic and conventional correction of SCS and MCS alter the head shape toward those of normal controls. However, in a qualitative evaluation, the average head shape after endoscopic technique for SCS and conventional correction for MCS appears to be closer to that of normal controls than after the alternative technique. This study reports on morphometric outcomes after craniosynostosis correction. Only an assessment of the whole multiplicity of outcome parameters based on multicenter data acquisition will allow conclusions of sup...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Matthias Schulz Linda Liebe-P üschel Karl Seelbach Laura Paulikat Felix Fehlhaber Karin Schwarz Christoph Blecher Ulrich-Wilhelm Thomale Source Type: research

Management of sagittal synostosis in the Synostosis Research Group: baseline data and early outcomes
CONCLUSIONS: The baseline severity of scaphocephaly was similar across procedures and sites. Treatment methods varied, but cranial vault remodeling and strip craniectomy both resulted in satisfactory postoperative CIs. Use of tranexamic acid may reduce the need for transfusion in cranial vault cases. The wide craniectomy technique for strip craniectomy seemed to be associated with change in CI. Both findings seem amenable to testing in a randomized controlled trial.PMID:33794498 | DOI:10.3171/2021.1.FOCUS201029 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Cordell M Baker Vijay M Ravindra Barbu Gociman Faizi A Siddiqi Jesse A Goldstein Matthew D Smyth Amy Lee Richard C E Anderson Kamlesh B Patel Craig Birgfeld Ian F Pollack Thomas Imahiyerobo John R W Kestle Synostosis Research Group Source Type: research

The need for overcorrection: evaluation of computer-assisted, virtually planned, fronto-orbital advancement using postoperative 3D photography
CONCLUSIONS: Postoperative measurement of the applied FOA on 3D photographs is a feasible and objective method for assessment of surgical results. The delta between the FOA correction planned with CAD/CAM and the achieved correction can be analyzed on postoperative 3D photographs. In the future, calculation of the amount of "overcorrection" needed to avoid relapse of the affected side(s) after FOA may be possible with the aid of these techniques.PMID:33794499 | DOI:10.3171/2021.1.FOCUS201026 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Nicole Frank Joerg Beinemann Florian M Thieringer Benito K Benitez Christoph Kunz Raphael Guzman Jehuda Soleman Source Type: research

Coronal and lambdoid suture evolution following total vault remodeling for scaphocephaly
CONCLUSIONS: This is the first study to report the postoperative skull response after the removal of normal patent sutures following total vault remodeling in patients with isolated sagittal synostosis. The reappearance of a neosuture is rather common, but its incidence depends on the type of suture. The outcome of the suture differs with the incidence of neosuture formation between these transverse sutures. This might imply genetic and functional differences among cranial sutures, which still have to be elucidated.PMID:33794500 | DOI:10.3171/2021.1.FOCUS201004 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Pierre-Aur élien Beuriat Alexandru Szathmari Julie Chauvel-Picard Arnaud Gleizal Christian Paulus Carmine Mottolese Federico Di Rocco Source Type: research

Partial suturectomy for phenotypical craniosynostosis caused by incomplete fusion of cranial sutures: a novel surgical solution
CONCLUSIONS: Minimally invasive direct excision of the involved portion of fused cranial sutures followed by helmet therapy for phenotypical craniosynostosis is a safe and effective treatment strategy. This technique is suitable for very young patients and appears to offer similar outcomes to complete suturectomy. Further studies are required to see if this approach reduces the deformity severity for patients requiring vault remodeling later in life.PMID:33794501 | DOI:10.3171/2021.1.FOCUS201024 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: David C Lobb Smruti K Patel Brian S Pan Jesse Skoch Source Type: research

Single-suture craniosynostosis and the epigenome: current evidence and a review of epigenetic principles
Neurosurg Focus. 2021 Apr;50(4):E10. doi: 10.3171/2021.1.FOCUS201008.ABSTRACTCraniosynostosis (CS) is a congenital disease that arises due to premature ossification of single or multiple sutures, which results in skull deformities. The surgical management of single-suture CS continues to evolve and is driven by a robust body of clinical research; however, the molecular underpinnings of CS remain poorly understood. Despite long-standing hypotheses regarding the interaction of genetic predisposition and environmental factors, formal investigation of the epigenetic underpinnings of CS has been limited. In an effort to catalyz...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Othman Bin Alamer Adrian E Jimenez Tej D Azad Source Type: research

Introduction. Controversies in the management of single-suture craniosynostosis
Neurosurg Focus. 2021 Apr;50(4):E1. doi: 10.3171/2021.1.FOCUS2130.NO ABSTRACTPMID:33794486 | DOI:10.3171/2021.1.FOCUS2130 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Concezio Di Rocco John R W Kestle Richard Hayward Jesse A Taylor Source Type: research

Hydrocephalus treatment in patients with craniosynostosis: an analysis from the Hydrocephalus Clinical Research Network prospective registry
CONCLUSIONS: This is the largest prospective study reported on children with craniosynostosis and hydrocephalus. Hydrocephalus in children with craniosynostosis most commonly occurs in syndromic patients and multisuture fusion. It is treated at varying ages; however, most patients undergo surgery for craniosynostosis prior to hydrocephalus treatment. While VPS treatment is performed more frequently, VPS and ETV are both reasonable options, with decreasing revision rates with increasing age, for the treatment of hydrocephalus associated with craniosynostosis.PMID:33794488 | DOI:10.3171/2021.1.FOCUS20979 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Christopher M Bonfield Chevis N Shannon Ron W Reeder Samuel Browd James Drake Jason S Hauptman Abhaya V Kulkarni David D Limbrick Patrick J McDonald Robert Naftel Ian F Pollack Jay Riva-Cambrin Curtis Rozzelle Mandeep S Tamber William E Whitehead John R W Source Type: research

Disappointing results of spring-assisted cranial vault expansion in patients with Crouzon syndrome presenting with sagittal synostosis
Neurosurg Focus. 2021 Apr;50(4):E12. doi: 10.3171/2021.1.FOCUS20739.ABSTRACTThe aim of this study was to report on a single center's experience with spring-assisted cranial vault expansion (SAE) in patients with Crouzon syndrome and sagittal suture synostosis. Strip craniotomy with SAE has resulted in successful outcomes with low complication and revision rates in patients with isolated scaphocephaly. However, recent experience suggests that outcomes in patients with Crouzon syndrome and sagittal synostosis (SS) who undergo SAE are less favorable compared with the outcomes of those who undergo frontobiparietal (FBP) expans...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Alexander T Wilson Linda Gaillard Sarah L Versnel Jochem K H Spoor Marie-Lise C van Veelen Irene M J Mathijssen Source Type: research

Improved cephalic index following early cranial vault remodeling in patients with isolated nonsyndromic sagittal synostosis
This study aimed to evaluate the authors' institutional experience of surgically treating SS using a modified subtotal cranial vault remodeling technique in a population-based cohort. Special attention was directed toward the effect of patient age at time of surgery on long-term CI outcome.METHODS: A retrospective analysis was conducted on all patients with isolated nonsyndromic SS who were surgically treated from 2003 to 2011. Data from electronic medical records were gathered. Eighty-two patients with SS were identified, 77 fulfilled inclusion criteria, and 72 had sufficient follow-up data and were included. CI during fo...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Arvid Frostell Maryam Haghighi Jiri Bartek Ulrika Sandvik Bengt Gustavsson Adrian Elmi-Terander Erik Edstr öm Source Type: research

Editorial. Is the helmet doing most of the job in the endoscopic correction of craniosynostosis?
Neurosurg Focus. 2021 Apr;50(4):E9. doi: 10.3171/2021.1.FOCUS2125.NO ABSTRACTPMID:33794491 | DOI:10.3171/2021.1.FOCUS2125 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Concezio Di Rocco Source Type: research

Ultra-early synostectomy and cranial remodeling orthoses in the management of craniosynostoses
CONCLUSIONS: The data show that ultra-early synostectomy is safe and not associated with increased complications compared with surgery performed between 3 and 6 months of age. Infants with multisuture synostosis had increased operative time, required blood transfusion, and were more likely to require a second operation.PMID:33794492 | DOI:10.3171/2021.1.FOCUS201014 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Aaron Mohanty Thomas S Frank Sharif Mohamed Kristalynne Godwin Gautam G Malkani Source Type: research

Impact of health disparities on treatment for single-suture craniosynostosis in an era of multimodal care
In this study, the authors aimed to evaluate the impact of race/ethnicity and insurance status on age of presentation/surgery in children with craniosynostosis to highlight potential disparities in healthcare access. Charts were reviewed for children with craniosynostosis at two tertiary care hospitals in New York City from January 1, 2014, to August 31, 2020. Clinical and demographic data were collected, including variables pertaining to family socioeconomic status, home address/zip code, insurance status (no insurance, Medicaid, or private), race/ethnicity, age and date of presentation for initial consultation, type of s...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Caitlin Hoffman Alyssa B Valenti Eseosa Odigie Kwanza Warren Ishani D Premaratne Thomas A Imahiyerobo Source Type: research

Editorial. Disparities in access to healthcare and the neurosurgeon
Neurosurg Focus. 2021 Apr;50(4):E14. doi: 10.3171/2021.1.FOCUS2124.NO ABSTRACTPMID:33794494 | DOI:10.3171/2021.1.FOCUS2124 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Richard Hayward Source Type: research

Sport participation and related head injuries following craniosynostosis correction: a survey study
The objective of this survey study was to describe sport participation and sport-related head injury in CS patients.METHODS: A 16-question survey related to child/parent demographics, CS surgery history, sport history, and sport-induced head injury history was made available to patients/parents in the United States through a series of synostosis organization listservs, as well as synostosis-focused Facebook groups, between October 2019 and June 2020. Sports were categorized based on the American Academy of Pediatrics groupings. Pearson's chi-square test, Fisher's exact test, and the independent-samples t-test were used in ...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Aaron M Yengo-Kahn Oluwatoyin Akinnusotu Alyssa L Wiseman Muhammad Owais Abdul Ghani Chevis N Shannon Michael S Golinko Christopher M Bonfield Source Type: research

Erratum. Biographies of international women leaders in neurosurgery
Neurosurg Focus. 2021 Apr;50(4):E16. doi: 10.3171/2021.3.FOCUS201096a.NO ABSTRACTPMID:33794496 | DOI:10.3171/2021.3.FOCUS201096a (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Katherine M Berry Source Type: research

Quantitative and qualitative comparison of morphometric outcomes after endoscopic and conventional correction of sagittal and metopic craniosynostosis versus control groups
CONCLUSIONS: This quantitative analysis confirms that the performed surgical techniques of endoscopic and conventional correction of SCS and MCS alter the head shape toward those of normal controls. However, in a qualitative evaluation, the average head shape after endoscopic technique for SCS and conventional correction for MCS appears to be closer to that of normal controls than after the alternative technique. This study reports on morphometric outcomes after craniosynostosis correction. Only an assessment of the whole multiplicity of outcome parameters based on multicenter data acquisition will allow conclusions of sup...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Matthias Schulz Linda Liebe-P üschel Karl Seelbach Laura Paulikat Felix Fehlhaber Karin Schwarz Christoph Blecher Ulrich-Wilhelm Thomale Source Type: research

Management of sagittal synostosis in the Synostosis Research Group: baseline data and early outcomes
CONCLUSIONS: The baseline severity of scaphocephaly was similar across procedures and sites. Treatment methods varied, but cranial vault remodeling and strip craniectomy both resulted in satisfactory postoperative CIs. Use of tranexamic acid may reduce the need for transfusion in cranial vault cases. The wide craniectomy technique for strip craniectomy seemed to be associated with change in CI. Both findings seem amenable to testing in a randomized controlled trial.PMID:33794498 | DOI:10.3171/2021.1.FOCUS201029 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Cordell M Baker Vijay M Ravindra Barbu Gociman Faizi A Siddiqi Jesse A Goldstein Matthew D Smyth Amy Lee Richard C E Anderson Kamlesh B Patel Craig Birgfeld Ian F Pollack Thomas Imahiyerobo John R W Kestle Synostosis Research Group Source Type: research

The need for overcorrection: evaluation of computer-assisted, virtually planned, fronto-orbital advancement using postoperative 3D photography
CONCLUSIONS: Postoperative measurement of the applied FOA on 3D photographs is a feasible and objective method for assessment of surgical results. The delta between the FOA correction planned with CAD/CAM and the achieved correction can be analyzed on postoperative 3D photographs. In the future, calculation of the amount of "overcorrection" needed to avoid relapse of the affected side(s) after FOA may be possible with the aid of these techniques.PMID:33794499 | DOI:10.3171/2021.1.FOCUS201026 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Nicole Frank Joerg Beinemann Florian M Thieringer Benito K Benitez Christoph Kunz Raphael Guzman Jehuda Soleman Source Type: research

Coronal and lambdoid suture evolution following total vault remodeling for scaphocephaly
CONCLUSIONS: This is the first study to report the postoperative skull response after the removal of normal patent sutures following total vault remodeling in patients with isolated sagittal synostosis. The reappearance of a neosuture is rather common, but its incidence depends on the type of suture. The outcome of the suture differs with the incidence of neosuture formation between these transverse sutures. This might imply genetic and functional differences among cranial sutures, which still have to be elucidated.PMID:33794500 | DOI:10.3171/2021.1.FOCUS201004 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Pierre-Aur élien Beuriat Alexandru Szathmari Julie Chauvel-Picard Arnaud Gleizal Christian Paulus Carmine Mottolese Federico Di Rocco Source Type: research

Partial suturectomy for phenotypical craniosynostosis caused by incomplete fusion of cranial sutures: a novel surgical solution
CONCLUSIONS: Minimally invasive direct excision of the involved portion of fused cranial sutures followed by helmet therapy for phenotypical craniosynostosis is a safe and effective treatment strategy. This technique is suitable for very young patients and appears to offer similar outcomes to complete suturectomy. Further studies are required to see if this approach reduces the deformity severity for patients requiring vault remodeling later in life.PMID:33794501 | DOI:10.3171/2021.1.FOCUS201024 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: David C Lobb Smruti K Patel Brian S Pan Jesse Skoch Source Type: research

Single-suture craniosynostosis and the epigenome: current evidence and a review of epigenetic principles
Neurosurg Focus. 2021 Apr;50(4):E10. doi: 10.3171/2021.1.FOCUS201008.ABSTRACTCraniosynostosis (CS) is a congenital disease that arises due to premature ossification of single or multiple sutures, which results in skull deformities. The surgical management of single-suture CS continues to evolve and is driven by a robust body of clinical research; however, the molecular underpinnings of CS remain poorly understood. Despite long-standing hypotheses regarding the interaction of genetic predisposition and environmental factors, formal investigation of the epigenetic underpinnings of CS has been limited. In an effort to catalyz...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Othman Bin Alamer Adrian E Jimenez Tej D Azad Source Type: research

Introduction. Controversies in the management of single-suture craniosynostosis
Neurosurg Focus. 2021 Apr;50(4):E1. doi: 10.3171/2021.1.FOCUS2130.NO ABSTRACTPMID:33794486 | DOI:10.3171/2021.1.FOCUS2130 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Concezio Di Rocco John R W Kestle Richard Hayward Jesse A Taylor Source Type: research

Hydrocephalus treatment in patients with craniosynostosis: an analysis from the Hydrocephalus Clinical Research Network prospective registry
CONCLUSIONS: This is the largest prospective study reported on children with craniosynostosis and hydrocephalus. Hydrocephalus in children with craniosynostosis most commonly occurs in syndromic patients and multisuture fusion. It is treated at varying ages; however, most patients undergo surgery for craniosynostosis prior to hydrocephalus treatment. While VPS treatment is performed more frequently, VPS and ETV are both reasonable options, with decreasing revision rates with increasing age, for the treatment of hydrocephalus associated with craniosynostosis.PMID:33794488 | DOI:10.3171/2021.1.FOCUS20979 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Christopher M Bonfield Chevis N Shannon Ron W Reeder Samuel Browd James Drake Jason S Hauptman Abhaya V Kulkarni David D Limbrick Patrick J McDonald Robert Naftel Ian F Pollack Jay Riva-Cambrin Curtis Rozzelle Mandeep S Tamber William E Whitehead John R W Source Type: research

Disappointing results of spring-assisted cranial vault expansion in patients with Crouzon syndrome presenting with sagittal synostosis
Neurosurg Focus. 2021 Apr;50(4):E12. doi: 10.3171/2021.1.FOCUS20739.ABSTRACTThe aim of this study was to report on a single center's experience with spring-assisted cranial vault expansion (SAE) in patients with Crouzon syndrome and sagittal suture synostosis. Strip craniotomy with SAE has resulted in successful outcomes with low complication and revision rates in patients with isolated scaphocephaly. However, recent experience suggests that outcomes in patients with Crouzon syndrome and sagittal synostosis (SS) who undergo SAE are less favorable compared with the outcomes of those who undergo frontobiparietal (FBP) expans...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Alexander T Wilson Linda Gaillard Sarah L Versnel Jochem K H Spoor Marie-Lise C van Veelen Irene M J Mathijssen Source Type: research

Improved cephalic index following early cranial vault remodeling in patients with isolated nonsyndromic sagittal synostosis
This study aimed to evaluate the authors' institutional experience of surgically treating SS using a modified subtotal cranial vault remodeling technique in a population-based cohort. Special attention was directed toward the effect of patient age at time of surgery on long-term CI outcome.METHODS: A retrospective analysis was conducted on all patients with isolated nonsyndromic SS who were surgically treated from 2003 to 2011. Data from electronic medical records were gathered. Eighty-two patients with SS were identified, 77 fulfilled inclusion criteria, and 72 had sufficient follow-up data and were included. CI during fo...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Arvid Frostell Maryam Haghighi Jiri Bartek Ulrika Sandvik Bengt Gustavsson Adrian Elmi-Terander Erik Edstr öm Source Type: research

Editorial. Is the helmet doing most of the job in the endoscopic correction of craniosynostosis?
Neurosurg Focus. 2021 Apr;50(4):E9. doi: 10.3171/2021.1.FOCUS2125.NO ABSTRACTPMID:33794491 | DOI:10.3171/2021.1.FOCUS2125 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Concezio Di Rocco Source Type: research

Ultra-early synostectomy and cranial remodeling orthoses in the management of craniosynostoses
CONCLUSIONS: The data show that ultra-early synostectomy is safe and not associated with increased complications compared with surgery performed between 3 and 6 months of age. Infants with multisuture synostosis had increased operative time, required blood transfusion, and were more likely to require a second operation.PMID:33794492 | DOI:10.3171/2021.1.FOCUS201014 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Aaron Mohanty Thomas S Frank Sharif Mohamed Kristalynne Godwin Gautam G Malkani Source Type: research

Impact of health disparities on treatment for single-suture craniosynostosis in an era of multimodal care
In this study, the authors aimed to evaluate the impact of race/ethnicity and insurance status on age of presentation/surgery in children with craniosynostosis to highlight potential disparities in healthcare access. Charts were reviewed for children with craniosynostosis at two tertiary care hospitals in New York City from January 1, 2014, to August 31, 2020. Clinical and demographic data were collected, including variables pertaining to family socioeconomic status, home address/zip code, insurance status (no insurance, Medicaid, or private), race/ethnicity, age and date of presentation for initial consultation, type of s...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Caitlin Hoffman Alyssa B Valenti Eseosa Odigie Kwanza Warren Ishani D Premaratne Thomas A Imahiyerobo Source Type: research

Editorial. Disparities in access to healthcare and the neurosurgeon
Neurosurg Focus. 2021 Apr;50(4):E14. doi: 10.3171/2021.1.FOCUS2124.NO ABSTRACTPMID:33794494 | DOI:10.3171/2021.1.FOCUS2124 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Richard Hayward Source Type: research

Sport participation and related head injuries following craniosynostosis correction: a survey study
The objective of this survey study was to describe sport participation and sport-related head injury in CS patients.METHODS: A 16-question survey related to child/parent demographics, CS surgery history, sport history, and sport-induced head injury history was made available to patients/parents in the United States through a series of synostosis organization listservs, as well as synostosis-focused Facebook groups, between October 2019 and June 2020. Sports were categorized based on the American Academy of Pediatrics groupings. Pearson's chi-square test, Fisher's exact test, and the independent-samples t-test were used in ...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Aaron M Yengo-Kahn Oluwatoyin Akinnusotu Alyssa L Wiseman Muhammad Owais Abdul Ghani Chevis N Shannon Michael S Golinko Christopher M Bonfield Source Type: research

Erratum. Biographies of international women leaders in neurosurgery
Neurosurg Focus. 2021 Apr;50(4):E16. doi: 10.3171/2021.3.FOCUS201096a.NO ABSTRACTPMID:33794496 | DOI:10.3171/2021.3.FOCUS201096a (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Katherine M Berry Source Type: research

Quantitative and qualitative comparison of morphometric outcomes after endoscopic and conventional correction of sagittal and metopic craniosynostosis versus control groups
CONCLUSIONS: This quantitative analysis confirms that the performed surgical techniques of endoscopic and conventional correction of SCS and MCS alter the head shape toward those of normal controls. However, in a qualitative evaluation, the average head shape after endoscopic technique for SCS and conventional correction for MCS appears to be closer to that of normal controls than after the alternative technique. This study reports on morphometric outcomes after craniosynostosis correction. Only an assessment of the whole multiplicity of outcome parameters based on multicenter data acquisition will allow conclusions of sup...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Matthias Schulz Linda Liebe-P üschel Karl Seelbach Laura Paulikat Felix Fehlhaber Karin Schwarz Christoph Blecher Ulrich-Wilhelm Thomale Source Type: research

Management of sagittal synostosis in the Synostosis Research Group: baseline data and early outcomes
CONCLUSIONS: The baseline severity of scaphocephaly was similar across procedures and sites. Treatment methods varied, but cranial vault remodeling and strip craniectomy both resulted in satisfactory postoperative CIs. Use of tranexamic acid may reduce the need for transfusion in cranial vault cases. The wide craniectomy technique for strip craniectomy seemed to be associated with change in CI. Both findings seem amenable to testing in a randomized controlled trial.PMID:33794498 | DOI:10.3171/2021.1.FOCUS201029 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Cordell M Baker Vijay M Ravindra Barbu Gociman Faizi A Siddiqi Jesse A Goldstein Matthew D Smyth Amy Lee Richard C E Anderson Kamlesh B Patel Craig Birgfeld Ian F Pollack Thomas Imahiyerobo John R W Kestle Synostosis Research Group Source Type: research

The need for overcorrection: evaluation of computer-assisted, virtually planned, fronto-orbital advancement using postoperative 3D photography
CONCLUSIONS: Postoperative measurement of the applied FOA on 3D photographs is a feasible and objective method for assessment of surgical results. The delta between the FOA correction planned with CAD/CAM and the achieved correction can be analyzed on postoperative 3D photographs. In the future, calculation of the amount of "overcorrection" needed to avoid relapse of the affected side(s) after FOA may be possible with the aid of these techniques.PMID:33794499 | DOI:10.3171/2021.1.FOCUS201026 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Nicole Frank Joerg Beinemann Florian M Thieringer Benito K Benitez Christoph Kunz Raphael Guzman Jehuda Soleman Source Type: research

Coronal and lambdoid suture evolution following total vault remodeling for scaphocephaly
CONCLUSIONS: This is the first study to report the postoperative skull response after the removal of normal patent sutures following total vault remodeling in patients with isolated sagittal synostosis. The reappearance of a neosuture is rather common, but its incidence depends on the type of suture. The outcome of the suture differs with the incidence of neosuture formation between these transverse sutures. This might imply genetic and functional differences among cranial sutures, which still have to be elucidated.PMID:33794500 | DOI:10.3171/2021.1.FOCUS201004 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Pierre-Aur élien Beuriat Alexandru Szathmari Julie Chauvel-Picard Arnaud Gleizal Christian Paulus Carmine Mottolese Federico Di Rocco Source Type: research

Partial suturectomy for phenotypical craniosynostosis caused by incomplete fusion of cranial sutures: a novel surgical solution
CONCLUSIONS: Minimally invasive direct excision of the involved portion of fused cranial sutures followed by helmet therapy for phenotypical craniosynostosis is a safe and effective treatment strategy. This technique is suitable for very young patients and appears to offer similar outcomes to complete suturectomy. Further studies are required to see if this approach reduces the deformity severity for patients requiring vault remodeling later in life.PMID:33794501 | DOI:10.3171/2021.1.FOCUS201024 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: David C Lobb Smruti K Patel Brian S Pan Jesse Skoch Source Type: research

Single-suture craniosynostosis and the epigenome: current evidence and a review of epigenetic principles
Neurosurg Focus. 2021 Apr;50(4):E10. doi: 10.3171/2021.1.FOCUS201008.ABSTRACTCraniosynostosis (CS) is a congenital disease that arises due to premature ossification of single or multiple sutures, which results in skull deformities. The surgical management of single-suture CS continues to evolve and is driven by a robust body of clinical research; however, the molecular underpinnings of CS remain poorly understood. Despite long-standing hypotheses regarding the interaction of genetic predisposition and environmental factors, formal investigation of the epigenetic underpinnings of CS has been limited. In an effort to catalyz...
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Othman Bin Alamer Adrian E Jimenez Tej D Azad Source Type: research

Introduction. Controversies in the management of single-suture craniosynostosis
Neurosurg Focus. 2021 Apr;50(4):E1. doi: 10.3171/2021.1.FOCUS2130.NO ABSTRACTPMID:33794486 | DOI:10.3171/2021.1.FOCUS2130 (Source: Neurosurgical Focus)
Source: Neurosurgical Focus - April 1, 2021 Category: Neurosurgery Authors: Concezio Di Rocco John R W Kestle Richard Hayward Jesse A Taylor Source Type: research