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Neusel C, Class D, Eckert AW, Firsching R, Göbel P, Götz D, Haase R, Jorch G, Köhn A, Kropf S, Patzer L, Schanze I, Zahl C, Rissmann A. Multicentre approach to epidemiological aspects of craniosynostosis in Germany. Br J Oral Maxillofac Surg 2018; 56:881-886. [PMID: 30360905 DOI: 10.1016/j.bjoms.2018.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/03/2018] [Indexed: 02/06/2023]
Abstract
We know of no current published data on the prevalence of craniosynostosis in Germany, so our objective in this study was to contribute to the limited knowledge of its epidemiology by assessing time trends, the frequency of prenatal diagnosis, and the timing of diagnosis and treatment. Data were collected in Saxony-Anhalt during the period 2000-17, and we designed a retrospective multicentre cohort study. The prevalence was 4.8 cases of craniosynostosis/10 000 births, and did not increase during that time. We compared the data of 91 patients with those of 273 controls. There were 75 boys and 16 girls (ratio 4.7:1). Fifty-one children had isolated craniosynostosis, consisting of 46 with a single-suture, and five with a multisuture, synostosis. Twenty-nine were associated with other congenital malformations, and 11 were syndromic. Three cases had been diagnosed prenatally, and 34 had skull deformities diagnosed immediately after birth at a mean (SD) age of 3.4 (4.7) months. The mean (SD) age at the time of first admission to hospital in one of the three surgical centres of Saxony-Anhalt was 5.9 (5.5) months, and 65 patients were operated on at a mean age of 9.1 (6.3) months. In contrast to published reports we found a prevalence of 4.8 cases of craniosynostosis/10 000 births that did not increase during the period 2000-16. Although we found a low prenatal detection rate, the diagnosis and treatment in this cohort study seemed timely.
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Affiliation(s)
- C Neusel
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
| | - D Class
- Universitaetsklinik fuer Neurochirurgie, Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - A W Eckert
- Department of Oral and Maxillofacial Surgery, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.
| | - R Firsching
- Universitaetsklinik fuer Neurochirurgie, Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - P Göbel
- Department of Paediatric Surgery and Paediatric Urology, Hospital St. Elisabeth and St. Barbara Halle (Saale), Mauerstraße 5, 06110 Halle (Saale), Germany.
| | - D Götz
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
| | - R Haase
- Department of Neonatology and Paediatric Intensive Care, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.
| | - G Jorch
- Department of Paediatrics, University Hospital Magdeburg, Leipziger Str. 44, Haus 10, 39120 Magdeburg, Germany.
| | - A Köhn
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
| | - S Kropf
- Institute of Biometry and Medical Informatics, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 2, 39120 Magdeburg, Germany.
| | - L Patzer
- Department of Paediatrics, Hospital St. Elisabeth and St. Barbara Halle (Saale), Mauerstraße 5, 06110 Halle (Saale), Germany.
| | - I Schanze
- Institute of Human Genetics, University Hospital Magdeburg, Leipziger Str. 44, Haus 1, Haus 39, Magdeburg, 39120 Germany.
| | - C Zahl
- Department of Oral and Maxillofacial Surgery, University Hospital Magdeburg, Leipziger Str. 44, Haus 19, 39120 Magdeburg, Germany.
| | - A Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
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Neusel C, Class D, Jorch G, Zahl C, Rißmann A. Schädeldeformitäten – bekommt das Krankheitsbild rechtzeitig die nötige Aufmerksamkeit? Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
BACKGROUND The results of using resorbable plates and screws (82% polylactic acid and 18% polyglycolic acid) in craniofacial surgery for the correction of craniosynostosis after more than 4 years of experience are presented. Special attention is focussed on the degree of stability and the clinical tissue response to the material employed to answer the question of whether the material is an adequate alternative to titanium. METHODS Thirty patients who had been treated with this method for craniosynostoses were examined at regular intervals regarding the shape and stability of the forehead region, visibility and palpability of the plates, and tissue reactions. RESULTS The technical handling of the osteosynthesis material proved to be simple and reliable. In one case the bone was not strong enough for the screw pitch. After an observation period of a maximum of 4 years and 1 month, the fixations were stable with no signs of adverse reactions. DISCUSSION If the long-term results remain favorable, we consider the use of resorbable material a promising method for the stabilization of segments in craniofacial surgery in children.
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Affiliation(s)
- D Weingart
- Klinik für Kiefer- und Gesichtschirurgie, Plastische Operationen, Katharinenhospital, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174 Stuttgart.
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Weingart D, Bublitz R, Michilli R, Class D. [Peri-osseous intracranial translocation of titanium osteosynthesis plates and screws after fronto-orbital advancement]. Mund Kiefer Gesichtschir 2001; 5:57-60. [PMID: 11272389 DOI: 10.1007/pl00010794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Perossoeus intracranial translocation or passive intracranial transmission of titanium osteosynthesis plates and screws in the growing skull following surgical craniosynostosis corrections, also referred to as the PIT effect, has been described in the literature since 1995. It is a phenomenon which has not received due attention until recently and is explained by appositional and resorptional remodeling processes in the growing skull. CASE REPORT AND DISCUSSION An impressive case of the PIT effect with a total intracranial dislocation of titanium plates and screws is used to demonstrate the problems associated with this phenomenon and to discuss the few clinical case reports in the English-language literature. The obvious advantages of a resorbable material are pointed out; however, it is still uncertain as to whether the resorption process is fast enough to avoid the PIT effect if used clinically.
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Affiliation(s)
- D Weingart
- Klinik für Kiefer- und Gesichtschirurgie, Plastische Operationen, Klinikum Stuttgart Katharinenhospital, Kriegsbergstrasse 60, 70174 Stuttgart
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Weingart D, Bublitz R, Michilli R, Class D. [Preliminary results of the use of resorbable plates and screws in craniofacial surgery]. Mund Kiefer Gesichtschir 1999; 3:165-7. [PMID: 10414116 DOI: 10.1007/s100060050123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In ten patients with craniosynostoses resorbable plates and screws (Lactosorb) consisting of poly-L-lactic acid (82%) and poly-glycolic acid (18%) were used to stabilize the segments after frontoorbital advancement. As our experience increased, an exact adaptation of the plates and simple handling proved to be possible. The plates were stable enough to retain a favorable functional and aesthetic result after redraping the soft tissue envelope. In one patient with Chotzen's syndrome the intended use of the resorbable material was abandoned: the thin osseous structures did not offer enough primary stability to the high pitch of the screws. During an observation period of up to 21 months no infection, exposure, instability or dislocation was observed. The clinical use of the resorbable material in frontoorbital advancement proved to be a stable method of segment fixation if the bone was of sufficient thickness. These promising preliminary results will have to observed in a larger group and over a longer period of time.
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Affiliation(s)
- D Weingart
- Klinik für Kiefer- und Gesichtschirurgie, Plastische Operationen, Katharinenhospital Stuttgart
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