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Abdolazim Ghalambor - One of the best experts on this subject based on the ideXlab platform.
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surgical outcome of simplified horse shoe technique with the traditional procedure in children with Trigonocephaly
Journal of Craniofacial Surgery, 2017Co-Authors: Abdoljalil Kalantar Hormozi, Vahid Dastgerdi, Abdolazim GhalamborAbstract:: Trigonocephaly is one of the most common types of craniosynostosis leading to triangular-shaped head and neurodevelopmental complications. Several surgical techniques have been suggested for its correction, but the newly suggested technique seems to have optimal outcomes compared with the traditional methods. Thus, the authors retrospectively evaluated the outcomes of the simplified horse-shoe technique with previous procedures performed on 169 children severe Trigonocephaly during 1996 to 2015 at Mofid Hospital, Tehran, Iran. Demographic data of the patients and the surgical outcomes and complications and the need for reoperation were recorded and scored using the Whitaker system. The male-to-female ratio was 2.75:1. The mean ± standard deviation age of all the patients at the time of surgery was 7.09 ± 7.5, 9.95 ± 7.71, 10.53 ± 6.57, and 10.59 ± 7.96 months for the traditional, horse-shoe, and simplified horse-shoe techniques, respectively. The total reoperation rate was 6.5% (4.7% in the traditional technique, 1.2% in the horse-shoe, and 0.6% in the simplified horse-shoe technique) (P < 0.001). The main reason for reoperation was hardware removal (in the traditional technique). Whitaker scoring showed no patients of class IV in any of the groups and no patients of class III and IV in simplified horse-shoe technique, but the difference in the Whitaker scores among the 3 groups was not statistically significant (P = 1.176). The new surgical technique is easier and simpler with fewer complications than the traditional technique and is suggested to be recommended for surgical treatment in children with Trigonocephaly, especially in younger children.
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Surgical Outcome of Simplified Horse-Shoe Technique With the Traditional Procedure in Children With Trigonocephaly.
Journal of Craniofacial Surgery, 2017Co-Authors: Abdoljalil Kalantar Hormozi, Vahid Dastgerdi, Abdolazim GhalamborAbstract:: Trigonocephaly is one of the most common types of craniosynostosis leading to triangular-shaped head and neurodevelopmental complications. Several surgical techniques have been suggested for its correction, but the newly suggested technique seems to have optimal outcomes compared with the traditional methods. Thus, the authors retrospectively evaluated the outcomes of the simplified horse-shoe technique with previous procedures performed on 169 children severe Trigonocephaly during 1996 to 2015 at Mofid Hospital, Tehran, Iran. Demographic data of the patients and the surgical outcomes and complications and the need for reoperation were recorded and scored using the Whitaker system. The male-to-female ratio was 2.75:1. The mean ± standard deviation age of all the patients at the time of surgery was 7.09 ± 7.5, 9.95 ± 7.71, 10.53 ± 6.57, and 10.59 ± 7.96 months for the traditional, horse-shoe, and simplified horse-shoe techniques, respectively. The total reoperation rate was 6.5% (4.7% in the traditional technique, 1.2% in the horse-shoe, and 0.6% in the simplified horse-shoe technique) (P
Cesare Colosimo - One of the best experts on this subject based on the ideXlab platform.
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orbito facial dysmorphology in patients with different degrees of Trigonocephaly severity quantitative morpho volumetric analysis in infants with non syndromic metopic craniosynostosis
Childs Nervous System, 2020Co-Authors: Rosalinda Calandrelli, Luca Massimi, Fabio Pilato, Antonio Marrazzo, Marco Panfili, Concezio Di Rocco, Cesare ColosimoAbstract:Craniofacial dysmorphology varies significantly along a wide spectrum of severity in metopic cranial synostosis (MCS). This study aimed to quantify craniofacial changes, in MCS, to investigate their relationships with the severity of Trigonocephaly. By combining the metopic ridge and interfrontal angles, we identified three groups of Trigonocephaly severity (mild group n.14, moderate group n.19, severe group n.18). We perform a quantitative analysis using high-resolution CT images evaluating (1) cranial fossae dimensions; (2) vault indices and ratios: interparietal/ intercoronal (IPD/ICD), interparietal/intertemporal (IPD/ITD), cephalic index, vertico-longitudinal index; (3) orbito-facial distances (midfacial depth, maxillary height, upper facial index, orbital distances, globe protrusions), maxilla and orbital volumes; (4) supratentorial (ICV) and infratentorial (PCFV) cranial volumes and supratentorial (WBV) and infratentorial (PCFBV) brain volumes. In all groups, middle skull base lengths and upper midface index were increased. In moderate and severe groups: anterior hemifossa lengths were reduced, IPD/ICD and vertico-longitudinal index were changed; midfacial depth, anterior, mild, and lateral interorbital distances were reduced; globe protrusions were increased. The comparison between moderate and severe groups showed an increase of both globe protrusions and IPD/ICD. Among all groups, ICV and WBV were reduced in the severe group. This morpho-volumetric study provides new insights in understanding the craniofacial changes occurring in infants at different severity of Trigonocephaly. The increase of globe protrusions and the reduction of supratentorial volumes found in the severe group reflect the severity of Trigonocephaly; these findings might have a clinical and surgical relevance.
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craniofacial sutural pattern and surgical management in patients with different degrees of Trigonocephaly severity
Journal of Computer Assisted Tomography, 2020Co-Authors: Rosalinda Calandrelli, Luca Massimi, Fabio Pilato, Antonio Marrazzo, Marco Panfili, Concezio Di Rocco, Cesare ColosimoAbstract:: The aim of this study was to identify quantitative tools to classify the severity of Trigonocephaly to guide surgical management and predict outcome. METHODS: We reviewed high-resolution computed tomography images of 59 patients with metopic synostosis. We assessed the craniofacial sutural pattern as well as interfrontal and metopic angles, and we related the frontal angulation degree with the sutural pattern, the surgical management, and clinical outcome. RESULTS: We identified 3 groups according to the severity of Trigonocephaly. No difference was found between the sutural pattern of nasion complex and severity, whereas the closure of zygomatic maxillary sutures increased with the severity degree (P < 0.05). The operative management was related to the severity degree (P < 0.001) and to the reduced age (P = 0.009). CONCLUSIONS: Interfrontal and metopic angles are complementary measurements to evaluate with high accuracy the degree of frontal angulation. In preoperative assessment, they may guide surgery decision in particular when the choice is not straightforward.
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Orbito-facial dysmorphology in patients with different degrees of Trigonocephaly severity: quantitative morpho-volumetric analysis in infants with non-syndromic metopic craniosynostosis
Child's Nervous System, 2019Co-Authors: Rosalinda Calandrelli, Luca Massimi, Fabio Pilato, Antonio Marrazzo, Marco Panfili, Concezio Di Rocco, Cesare ColosimoAbstract:Purpose Craniofacial dysmorphology varies significantly along a wide spectrum of severity in metopic cranial synostosis (MCS). This study aimed to quantify craniofacial changes, in MCS, to investigate their relationships with the severity of Trigonocephaly. Methods By combining the metopic ridge and interfrontal angles, we identified three groups of Trigonocephaly severity (mild group n.14, moderate group n.19, severe group n.18). We perform a quantitative analysis using high-resolution CT images evaluating (1) cranial fossae dimensions; (2) vault indices and ratios: interparietal/ intercoronal (IPD/ICD), interparietal/intertemporal (IPD/ITD), cephalic index, vertico-longitudinal index; (3) orbito-facial distances (midfacial depth, maxillary height, upper facial index, orbital distances, globe protrusions), maxilla and orbital volumes; (4) supratentorial (ICV) and infratentorial (PCFV) cranial volumes and supratentorial (WBV) and infratentorial (PCFBV) brain volumes. Results In all groups, middle skull base lengths and upper midface index were increased. In moderate and severe groups: anterior hemifossa lengths were reduced, IPD/ICD and vertico-longitudinal index were changed; midfacial depth, anterior, mild, and lateral interorbital distances were reduced; globe protrusions were increased. The comparison between moderate and severe groups showed an increase of both globe protrusions and IPD/ICD. Among all groups, ICV and WBV were reduced in the severe group. Conclusion This morpho-volumetric study provides new insights in understanding the craniofacial changes occurring in infants at different severity of Trigonocephaly. The increase of globe protrusions and the reduction of supratentorial volumes found in the severe group reflect the severity of Trigonocephaly; these findings might have a clinical and surgical relevance.
Joachim A Obwegeser - One of the best experts on this subject based on the ideXlab platform.
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assessing aesthetic outcomes after Trigonocephaly correction
Oral and Maxillofacial Surgery, 2014Co-Authors: Philipp Metzler, Wolfgang Zemann, Christine Jacobsen, Heinztheo Lubbers, Klaus W Gratz, Joachim A ObwegeserAbstract:Purpose This study analysed the aesthetic outcome assessments after Trigonocephaly correction using different assessor groups.
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cranial vault growth patterns of plagiocephaly and Trigonocephaly patients following fronto orbital advancement a long term anthropometric outcome assessment
Journal of Cranio-maxillofacial Surgery, 2013Co-Authors: Philipp Metzler, Wolfgang Zemann, Christine Jacobsen, Klaus W Gratz, Joachim A ObwegeserAbstract:Abstract Fronto-orbital advancement (FOA) is the most common technique used to correct plagiocephaly and Trigonocephaly. The aim of this study was to investigate the cranial vault growth following FOA and to compare the growth pattern to the normal standard. Fifty-two Swiss children (25 with anterior plagiocephaly and 27 with Trigonocephaly) between the surgical ages of 8 and 10 months were included in this 5-year follow-up study. A standardised time protocol (before the procedure; 6 weeks and 6 months after the surgery; and then annually until the age of six) for anthropometric skull measurements (head circumference, cranial length, and breadth and cephalic indices) was used to analyse the pre- and post-operative cranial vault growth patterns. Data were converted into the Z -score for standardised inter-centre comparison. For all the patients, a significant improvement in the shape of the cranial vault following FOA was observed. In both the plagiocephaly and Trigonocephaly groups, the long-term cranial growth patterns (head circumference and cranial length and breadth) significantly differed following this procedure in comparison to those of the control group. The cephalic indices remained constant; no significant changes were found in either study population. Fronto-orbital advancement in anterior craniosynostotic patients between the ages of 8 and 10 months seems to be ideal, as the procedure promotes solid cranial vault growth, ensuring positive surgical results.
M J Earley - One of the best experts on this subject based on the ideXlab platform.
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Behavioral, developmental, and educational problems in children with nonsyndromic Trigonocephaly.
Journal of neurosurgery, 2020Co-Authors: Michael O Kelleher, Dylan J Murray, Anne Mcgillivary, Mahmoud Hamdy Kamel, David Allcutt, M J EarleyAbstract:The neurobehavioral morbidity of nonsyndromic Trigonocephaly is incompletely understood. The purpose of this study was twofold: first, to assess the degree of developmental, educational, and behavioral problems in patients with nonsyndromic Trigonocephaly and second, to establish whether patients with mild degrees of Trigonocephaly had a lower frequency of such problems. The authors performed an observational study of the frequency of developmental, educational, and behavioral problems in 63 children with Trigonocephaly at the National Craniofacial Centre in the Republic of Ireland between 1989 and 2004. The parents of the children completed a follow-up questionnaire. Thirty percent of patients had a mild form of Trigonocephaly and were treated conservatively. The remainder underwent surgical correction. Speech and/or language delay was reported in 34% of the children. Thirty-three percent of the children needed to be assessed by a school psychologist, and 47% were receiving remedial or resource hours within the school system. Twenty percent of children required a special needs classroom assistant because of behavioral issues, and 37% of parents expressed concerns about their child's behavior. There were no statistically significant differences between children treated with surgery and those who had a mild deformity and were treated conservatively. Nonsyndromic Trigonocephaly is associated with a high frequency of developmental, educational, and behavioral problems. The frequency of these problems is not related to the severity of the Trigonocephaly.
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non syndromic Trigonocephaly surgical decision making and long term cosmetic results
Childs Nervous System, 2007Co-Authors: Michael Kelleher, Dylan J Murray, Anne Mcgillivary, David Allcutt, Mahmoud Kamel, M J EarleyAbstract:Background Surgical correction is often required for cosmetic correction of Trigonocephaly. The purpose of this paper was to report the long-term aesthetic outcome as appreciated by the parents/patients themselves. The self-evaluation of cosmetic outcome after Trigonocephaly correction has not previously been reported. The management and different surgical techniques utilized over a 16-year period are discussed.
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behavioral developmental and educational problems in children with nonsyndromic Trigonocephaly
Journal of Neurosurgery, 2006Co-Authors: Michael Kelleher, Dylan J Murray, Anne Mcgillivary, Mahmoud Hamdy Kamel, David Allcutt, M J EarleyAbstract:Object The neurobehavioral morbidity of nonsyndromic Trigonocephaly is incompletely understood. The purpose of this study was twofold: first, to assess the degree of developmental, educational, and behavioral problems in patients with nonsyndromic Trigonocephaly and second, to establish whether patients with mild degrees of Trigonocephaly had a lower frequency of such problems. Methods The authors performed an observational study of the frequency of developmental, educational, and behavioral problems in 63 children with Trigonocephaly at the National Craniofacial Centre in the Republic of Ireland between 1989 and 2004. The parents of the children completed a follow-up questionnaire. Thirty percent of patients had a mild form of Trigonocephaly and were treated conservatively. The remainder underwent surgical correction. Speech and/or language delay was reported in 34% of the children. Thirty-three percent of the children needed to be assessed by a school psychologist, and 47% were receiving remedial or resource hours within the school system. Twenty percent of children required a special needs classroom assistant because of behavioral issues, and 37% of parents expressed concerns about their child's behavior. There were no statistically significant differences between children treated with surgery and those who had a mild deformity and were treated conservatively. Conclusions Nonsyndromic Trigonocephaly is associated with a high frequency of developmental, educational, and behavioral problems. The frequency of these problems is not related to the severity of the Trigonocephaly.
T Javed - One of the best experts on this subject based on the ideXlab platform.
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modifications in the surgical correction of Trigonocephaly
Plastic and Reconstructive Surgery, 1990Co-Authors: A M Sadove, J E Kalsbeck, Barry L Eppley, T JavedAbstract:: A modified technique for the surgical correction of Trigonocephaly is presented. The technical modifications are designed both to increase the stability of fixation of the supraorbital bar and lateral canthal advancements and to increase interorbital distance and anterior cranial fossa volume when utilized in those patients who exhibit the full expression of Trigonocephaly, including midline ridging, bifrontal recession, hypotelorbitism, shortened anterior cranial fossa, deficient projection of lateral orbit, and bitemporal narrowing. It is a modification of the supraorbital bar remodeling/advancement procedure as originally described by Marchac with the introduction of a nasofrontal osteotomy and superior osteotomy bone graft and midline miniplate fixation of the supraorbital bar to the nasofrontal junction. Its use in 20 patients has been favorable.
