Evaluation of Helmeting Therapy Duration After Endoscopic Strip Craniectomy for Metopic and Sagittal Craniosynostosis

Huan T Nguyen; George N Washington; Alfredo Cepeda Jr; Tim Littlefield; John F Teichgraeber; Matthew R Greives; Phuong D Nguyen

doi:10.1097/SCS.0000000000009887

Evaluation of Helmeting Therapy Duration After Endoscopic Strip Craniectomy for Metopic and Sagittal Craniosynostosis

J Craniofac Surg. 2023 Nov 16. doi: 10.1097/SCS.0000000000009887. Online ahead of print.

Authors

Huan T Nguyen¹, George N Washington², Alfredo Cepeda Jr³, Tim Littlefield⁴, John F Teichgraeber², Matthew R Greives², Phuong D Nguyen²

Affiliations

¹ The University of Texas Health Science Center at Houston, McGovern Medical School.
² Division of Plastic Surgery, Department of Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School & Children's Memorial Hermann Hospital.
³ Department of Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX.
⁴ Cranial Technologies, Chandler, AZ.

PMID: 37973053
DOI: 10.1097/SCS.0000000000009887

Abstract

Introduction: Endoscopic strip craniectomy (ESC) is a minimally invasive option for early surgical treatment of metopic (MC) and sagittal craniosynostosis (SC). For ESC, however, the postoperative duration and compliance of helmet therapy are crucial to correct MC and SC asymmetry. The purpose of this study is to assess the period of postoperative band therapy and determine differences, if any, between MC and SC.

Methods: A single-institution retrospective review was performed for patients with MC and SC who underwent ESC from November 2015 to 2019. Patients received preoperative, postoperative, and post-band 3-dimensional imaging. Factors recorded included patient sex, insurance type, number of helmets needed, age at surgery, time of first helmet, and at time of completion of helmet therapy, cephalic index, interfrontal angle, and cranial vault asymmetry index.

Results: Patients with SC and MC had ESC surgery at 3.3 and 3.4 months of age, respectively.Patients with SC were found to have completed banding therapy at a younger age (7.88 versus 10.0 mo), with shorter duration (4.17 versus 6.00 mo), and less number of bands (1.54 versus 2.21) than patients with MC. After regression analysis, suture type was found to be a significant predictor of total time in band therapy (P=0.039) with MC requiring a longer duration of banding therapy when compared with SC.

Conclusions: Suture type directly correlates with duration of helmeting therapy for patients, with patients with MC requiring longer periods of postop helmeting and increased number of bands as compared with SC.