Postoperative cognitive outcome for synostotic frontal plagiocephaly.

OBJECT: The goals of this study were to evaluate the cognitive outcome after surgery for synostotic frontal plagiocephaly and to compare the effects of early (< 1 year of age) and late (> or = 1 year of age) surgical correction on intellectual development.

METHODS

In a prospective study involving 220 patients, both preoperative and postoperative cognitive function were measured using developmental quotient (DQ) or intelligence quotient (IQ) determination. Preoperative intracranial pressure (ICP) was also measured, and the presence of the fibroblast growth factor receptor 3 (FGFR3) P250R mutation was assessed.

CONCLUSIONS

Preoperative DQ/IQ was not affected by patient age at the time of surgery. There was no statistically significant difference in mean postoperative IQ between patients who underwent surgery before 1 year of age and those who underwent surgery at 1 year of age or older. In the latter group, there was a statistically significant increase in the incidence of elevated ICP (> or = 15 mm Hg in 16%), but no effect on cognitive outcome was observed. Likewise, there was no statistically significant correlation between the presence of the FGFR3 mutation and postoperative IQ. The indication for surgical correction appears to be largely cosmetic.