Comparison of Neurocognitive Outcomes in Postoperative Adolescents with Unilateral Coronal Synostosis.

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Tytuł:: Comparison of Neurocognitive Outcomes in Postoperative Adolescents with Unilateral Coronal Synostosis.
Autorzy:: Wu RT; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Gabrick KS; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Singh A; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Landi N; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Taylor JA; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Bartlett SP; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Persing JA; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Alperovich M; From the Section of Plastic and Reconstructive Surgery, Department of Surgery, and the Yale Child Study Center, Yale University School of Medicine; and the Division of Plastic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania.
Źródło:: Plastic and reconstructive surgery [Plast Reconstr Surg] 2020 Sep; Vol. 146 (3), pp. 614-619.
Typ publikacji:: Journal Article; Randomized Controlled Trial
Język:: English
Imprint Name(s):: Publication: : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore : Williams & Wilkins,
MeSH Terms:: Academic Success*
Reading*
Craniosynostoses/*surgery
Plastic Surgery Procedures/*methods
Visual Perception/*physiology
Adolescent ; Child ; Craniosynostoses/physiopathology ; Double-Blind Method ; Female ; Follow-Up Studies ; Humans ; Male ; Neuropsychological Tests ; Postoperative Period ; Prospective Studies
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Entry Date(s):: Date Created: 20200826 Date Completed: 20200922 Latest Revision: 20221207
Update Code:: 20240105
DOI:: 10.1097/PRS.0000000000007067
PMID:: 32842112
: Czasopismo naukowe

Unilateral coronal nonsyndromic craniosynostosis is associated with asymmetric skull growth, which may influence cerebral long-term function. Twenty affected adolescents who underwent cranial vault remodeling at a mean age of 8.2 months (12 from the Yale Craniofacial Clinic and eight from the Children's Hospital of Philadelphia) all completed a double-blinded neurodevelopmental assessment at an average age of 12.1 years. The study cohort included 55 percent female and 50 percent right-sided craniosynostosis. Mean verbal intelligence quotient was highest at 117.3, and mean performance intelligence quotient was 106.4, for a mean full-scale intelligence quotient of 112.5. Patients performed above the national average on all academic achievements except for numerical operations, which was significantly lower than word reading (p = 0.022). Patients performed below average on all Beery-Buktenica visual motor tests; motor-coordination was poorer than both visual motor integration and visual perception (p = 0.027 and p = 0.005). Significant positive correlations existed between paternal education/visual perception (r = 0.450; p = 0.046) and household income/verbal intelligence quotient (r = 0.628; p = 0.004). Patients with right unilateral coronal nonsyndromic craniosynostosis had improved spelling compared with left-sided patients on multivariate regression (p = 0.033). Female patients had higher motor coordination (p = 0.024). Breast-fed patients had better performance intelligence quotient (p = 0.024), visual motor integration (p = 0.014), and visual perception (p = 0.031). Adolescents who underwent cranial vault remodeling at two institutions had above average intelligence quotient scores, but worse mathematical and visual motor achievement compared with control subjects. Left-side craniosynostosis patients performed worse in spelling than right-side patients. Breast-feeding was an independent predictor for improved performance intelligence quotient, visual motor achievement, and visual perception performance. Study findings are limited by the cohort size. A larger population study is required, which could validate or modify the study conclusions.

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