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The utility and post-operative evolution of head circumference in nonsyndromic single-suture craniosynostosis: a prospective study in Vietnamese children

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Abstract

Purpose

Head circumference (HC) is an important clinical tool for following head growth in children with craniosynostosis (CS). The purpose of this study is to quantify the usefulness of HC along continuum of CS care, from diagnosis to pre- and post-operative (pre-op, post-op) follow-up in Vietnamese children.

Methods

A prospective cohort of 54 nonsyndromic single-suture CS patients undergoing open surgery from January 2015 to January 2020 was collected at Children’s Hospital 2, Vietnam. HC z-score on admission was compared with World Health Organization (WHO) standards to evaluate for utility in initial diagnosis. Pre-op and post-op HC were compared to demonstrate the evolution of head growth following reconstruction.

Results

Nonsyndromic single-suture CS was more predominant in males (79.6%) than in females (20.4%). The mean HC z-score was − 0.38 \(\pm\) 1.29 similar to normal WHO standards regardless of which sutural involvement. The HC z-score increased above + 1 standard deviation (SD) significantly at 3 months of follow-up (p < 0.001); however, the trajectory gradually decreased after the first year of surgery. One patient (1.8%, 1/54) demonstrated restenosis and delayed intracranial hypertension (DIH) 4 years after reconstruction.

Conclusions

The HC in nonsyndromic single-suture CS children presents similarly to the values of healthy children. Additionally, HC reliably increased after reconstruction and gradually normalized over subsequent years. This indicator is consistent in Southeast Asian populations and should be used to follow all patients to assess the normal progression of post-op head growth and as a useful indicator of suspected recurrent synostosis.

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Abbreviations

CS:

Craniosynosynostosis

HC:

Head circumference

CH2:

Children’s Hospital 2

COA:

Children’ of Alabama

CRV:

Cranial vault remodeling

FOA:

Fronto-orbital advancement

Pre-op:

Pre-operative

Post-op:

Post-operative

SD:

Standard deviation

ICP:

Intracranial pressure

DIH:

Delayed intracranial hypertension

WHO:

World Health Organization

CDC:

Centers for Disease Control and Prevention

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Acknowledgements

We would like to thank Dr. Nguyen Minh Duc for proofreading the manuscript.

Author information

Authors and Affiliations

  1. Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam

    Dang Do Thanh Can & Pham Anh Tuan

  2. Department of Neurosurgery, Children’s Hospital 2, Ho Chi Minh City, Vietnam

    Dang Do Thanh Can

  3. Department of Pediatric Surgery, Children’s Hospital 2, Ho Chi Minh City, Vietnam

    Pham Ngoc Thach

  4. Department of Neurological Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

    Jacob R. Lepard & James M. Johnston

  5. Section of Pediatric Neurosurgery, Children’s of Alabama, Birmingham, AL, USA

    Jacob R. Lepard & James M. Johnston

  6. Department of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

    John H. Grant

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  1. Dang Do Thanh Can
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  4. Pham Anh Tuan
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Contributions

CDDT contributed to all stages of data collection, statistical analysis, and draft presentation. LRJ, TNP, TAP, JMJ, and GHJ revised the manuscript. All authors approved the final version of the manuscript for submission.

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Correspondence to Dang Do Thanh Can.

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This study was approved by the Biomedical Research Ethics Committee of UMP (Ethics approval number: 357/UMP).

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Can, D.D., Lepard, J.R., Thach, P.N. et al. The utility and post-operative evolution of head circumference in nonsyndromic single-suture craniosynostosis: a prospective study in Vietnamese children. Childs Nerv Syst 39, 471–479 (2023). https://doi.org/10.1007/s00381-022-05580-x

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