The effects of craniectomy compared to cranial vault remodeling on morphological, functional and neurological outcomes in infants with isolated non-syndromic sysnostosis of the sagittal suture: a systematic review protocol

Abstract

Review question/objective The objectives of this review are to identify the effectiveness of craniectomy on morphological, functional and neurological outcomes in isolated sagittal synostosis. More specifically, the objectives are to identify: The effectiveness of craniectomy compared with cranial vault remodeling on morphological, functional and neurological outcomes in human infants with isolated non-syndromic sagittal synostosis. Inclusion criteria Types of participants This review will consider studies that include male and female human infants with clinically and/or radiologically diagnosed primary isolated sagittal synostosis. It will not look at animal studies as these have no clinical application. The review will not include studies of secondary sagittal synostosis, syndromic cases with other anomalies, or scaphocephaly from causes other than sagittal synostosis, as these may act as confounding factors in the postoperative outcomes. In studies where other sutures have been treated at least half of the cases must be isolated sagittal suture. The review will not include studies of children with mental and developmental impairments from known causes other than sagittal synostosis, as again this may influence the cognitive and developmental outcomes separately to the synostosis. The review will consider studies with mean age at time of surgery less than 24 months. This has been selected as the cut-off with the intention of preventing further deformity, the potential for complications in this period and to enable the theoretical normal reconfiguration of the growing skull. Types of intervention(s)/phenomena of interest This review will consider studies that investigate craniectomy methods, both endoscopic and non-endoscopic, compared with the control of cranial vault remodeling. The review will not consider studies that evaluate outcomes of spring cranioplasty nor non-surgical interventions, e.g. helmet therapy in the absence of surgery, as these are separate interventions within themselves. Types of outcomes This review will consider studies that include the following outcome measures: • Morphological outcomes • Functional outcomes • Neurological outcomes The primary outcome for consideration will be (skull) morphology measured by cephalic index. Cephalic index is easily and non-invasively measured and provides an objective measure that allows statistical comparison within and between samples. Cephalic index can be calculated from direct TRUNCATED AT 350 WORDS