Artikel
Influence of surgical treatment on the development of children with non-syndromal craniosynostosis
Einfluss der operativen Behandlung auf die Entwicklung von Kindern mit nonsyndromomaler Kraniosynostose
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Veröffentlicht: | 30. Mai 2008 |
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Objective: Since the very beginning of the surgical treatment of craniosynostosis, there has been a controversial discussion whether this entity is a disease or simply an alteration of appearance. Up until now we have no hints of morphological symptoms as papilledema or physiological symptoms like increased intracranial pressure. However, some authors discuss a delay of motor, speech, social and emotional development. To support this hypothesis, we performed the following investigation.
Methods: From 9-1-2002 to 8-1-2006, 52 conservatively and operatively treated children with non syndromal craniosynostosis were tested with the developmental test ET 6-6, Petermann and Stein before treatment, immediately after operation and after 12 further months. We performed a non randomized and open labeled cohort study. The variables were surgical vs. non surgical treatment and the parameters of ET 6-6 (movement, cognition, memory, strategies of handling, speech understanding and production ...).
Results: Statistical analysis was performed including Four-field table, Odd's ratio, Control Event Rate, Experimental Event Rate, Absolute Reduction of Risk, Relative Risk, Number Needed to Treat, U-Test of Mann-Whitney, and Wilcoxon-Test. In conclusion, statistical results showed no significant difference between both groups of patients. E.g., deficits of body movement were found in 60% vs. 62,5%, speech development was delayed in 60% vs. 50 % for conservatively and operatively treated children at the time of the very last testing.
Conclusions: While children with non-syndromal craniosynostosis sometimes suffer of deficits mainly of psychomotoric and mental development, some other dimensions improved significantly after operative treatment. However, in comparison to non-surgically treated children there was no gross difference. In conclusion, our study has shown no positive effect of operative treatment on the development of children with non-syndromal craniosynostosis.