Impact of barrel stave osteotomy on cephalometric measurements in patients who have undergone endoscopic repair of sagittal craniosynostosis
Bibliographic record
Abstract
OBJECTIVE: The treatment of sagittal craniosynostosis typically involves endoscopic suturectomy (ES) to allow skull expansion, followed by postoperative helmet orthosis, resulting in an improvement in cranial deformity as assessed using the cephalic index (CI). The impact of variations in surgical technique on long-term CI outcomes is not well understood, and there is controversy regarding whether adding barrel stave osteotomy (BSO) to standard ES leads to greater improvement in the CI postoperatively. This combined approach is thought to improve cranial shape and overall clinical outcomes but may increase operative burden. The aim of this study was to investigate the impact of BSO during ES on operative outcomes and postoperative cranial deformity in patients who underwent surgical correction of sagittal craniosynostosis. METHODS: The authors conducted a retrospective chart review of children who had been treated with ES for sagittal craniosynostosis between 2010 and 2021 at British Columbia Children's Hospital. Demographics, operative outcomes, and postoperative longitudinal CI measurements were collected and compared between patients who had undergone ES with BSO (ES+BSO) and those who had undergone ES alone. Operative outcomes related to anesthesia and surgical time, blood loss, and hospital length of stay were analyzed, as were changes in the CI at various follow-up times. A mixed-effects model was used to compare longitudinal CI measurements between treatment groups, controlling for patient age, preoperative CI, and duration of helmet therapy. RESULTS: Eighty-five patients were included in the analysis, 67 treated with ES+BSO and 18 treated with ES. Operative outcomes, including length of hospital stay, operative time, time under anesthesia, blood loss, and need for transfusion did not differ significantly between treatment groups (p > 0.05). The mean follow-up for the last CI measurements was 56.0 months. While preoperative CI was similar for the two groups (mean 67.4 for ES+BSO vs 66.8 for ES, p = 0.61), CI was significantly higher in the ES+BSO group immediately postoperatively (p = 0.004) and at the 6-month (p = 0.01), 2-year (p = 0.02), and final (p = 0.002) follow-ups. A mixed-effects model revealed that the addition of BSO led to significantly greater CI measurements independent of age, preoperative CI, and helmeting duration (estimated effect size 2.21, p = 0.001). CONCLUSIONS: In this series, the addition of BSO to ES significantly improved immediate and long-term cranial deformity in patients with sagittal craniosynostosis, without increasing the operative burden.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".