Endoscopic correction for trigonocephaly: current state of the problem and analysis of own treatment results

SUMMARY. Trigonocephaly (TC) is a common form of craniosynostosis (10 %). Surgical treatment of patients with TC is traditionally performed by bilateral frontoorbital reconstruction. Minimally invasive endoscopic (ESE) correction in TC has become an effective, safe alternative to open reconstructive surgery. The choice between traditional reconstructive surgery and endoscopic should be carried out with full disclosure of the features of treatment options, therefore, additional study of the advantages and disadvantages of ESE is required.

PURPOSE of this retrospective study is to analyze the results using ESE in combination with cranial orthosis therapy (COT).

MATERIALAND METHODS.  The results of treatment of 22 patients with TC (13 (59 %) boys and 9 (41 %) girls) aged 3.09±0.81 months were analyzed. The study of the clinical status before and after treatment, cephalometric examination to assess the morphological result, as well as the evaluation of the aesthetic result using visual analog scales (VAS) and questionnaires of the parents of patients.

RESULTS. Hemotransfusion was performed in 7 (31.8 %) cases. The duration of surgery was 35.91±8.82 min. The volume of blood loss was 40±32.66 ml. The duration of COT was 8.43±3.74 months. Repeated surgical interventions were performed in 3 cases. A significant increase in the frontal angle was revealed. The ratio of the interfrontal and interparietal diameters was less than normal values, both before and after treatment. The analysis of deformity according to the VAS and 10-point scale revealed significant differences in the shape of the patients’ heads before and after treatment.

CONCLUSION. Endoscopic suturectomy at TC, performed at the optimal time, in an adequate volume and accompanied by optimal COT, allows achieving good and satisfactory functional and aesthetic results in most cases. The immediate morphological results of treatment significantly differ from the preoperative ones, but also differ from the parameters of healthy children. The result of treatment is delayed and can be achieved with proper adherence to the treatment protocol by the patient’s parents and attending physicians. The significant advantages of the method are the absence of an extended postoperative scar, the relatively mild course of the postoperative period, the relatively low probability of blood loss and necessary hemotransfusion, the possibility of shortening the period of inpatient treatment of the patient, the low frequency of undesirable consequences and complications.

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