Long-term subjective patient's satisfaction and aesthetic outcomes in sagittal synostosis: a study of 488 patients operated by early, wide, open strip craniectomy.

OBJECTIVE

Infants with sagittal synostosis (SS) are operated upon mainly for cosmetic reasons. The patient's perception related to head shape and to scar, are mostly subjective. We therefore investigated the long term subjective results of relatively homogeneous group of children who were operated on with an early, open, and wide strip craniectomy.

METHODS

Single-center, retrospective study with a follow-up of 2 to 25 years. The study cohort included 488 children who underwent early, open, wide, strip craniectomy for SS at the age of 2-4 months and answered the telephone questionnaire. We interviewed the parents, assessing their perception, adding upon the children's related feelings. The questionnaire included both quantitative ratings and qualitative responses "pearls", and assessed aesthetic outcomes, including skull shape, scar-related concerns, and overall satisfaction. The cohort was stratified into three age groups (3-6, 6-12, and ≥ 12 years), and a comparative analysis between males and females.

RESULTS

488 patients responded to the questionnaire. There is an overall very high satisfaction with the surgery's aesthetic results. Except for one patient (1/488), all responders stated that they would undergo the surgery again. Detailed questions about head shape and the influence of the scar, show mostly minor comments that seem to improve when we compare those between 6 and 12, and those above 12 years of age. Scar-related concerns were generally mild in nature (such as local sensitivity, pruritus, or difficulty with haircuts) and did not translate into overall dissatisfaction.

CONCLUSIONS

This study confirms that the long-term subjective, aesthetic results of early, wide, open and strip craniectomy of both parents and children are excellent. Despite the presence of minor aesthetic concerns, including scar-related findings, overall satisfaction remains consistently high.