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Cover illustration: Metopica synostosis
Cover illustration: Metopica synostosis
Photo: Enaya Søfteland
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Madiha Bhatti-Søfteland -Metopic synostosis - surgical results and perinatal aspects

Published

On May 13, Madiha Bhatti-Søfteland defended her thesis for Doctor of Medical Science at the Institute of Clinical Sciences, Sahlgrenska Academy, in the research subject of plastic surgery.

The title of the thesis is: Metopic synostosis - surgical results and perinatal aspects

Link directly to the doctoral thesis and the whole abstract

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Photo: Madiha Bhatti-Søfteland, plastic surgeon active at the plastic surgery clinic Sahlgrenska University Hospital.
Madiha Bhatti-Søfteland, plastic surgeon active at the plastic surgery clinic Sahlgrenska University Hospital.
Photo: Åsa Bell

ABSTRACT:
Metopic synostosis (MS) is the second most common type of craniosynostosis (CS). This thesis aimed to evaluate surgical results in children operated for MS, their perinatal outcomes and potential etiological risk factors.

Methods:
In study I, we measured the distribution of frontal and intracranial volume ratio at
6-months postoperatively to determine relapse.
Study II measured the degree of bony
temporal hollowing before and after surgery.
Study III assessed three grading scales for
complication reporting in craniofacial surgery.
Studies IV and V used data from the Swedish

Birth Register to study perinatal outcomes in collaboration with the Netherlands (study IV) and evaluate aetiological factors in CS (study V)
.

3D CT skull reconstruction illustrating MS of varying severity from severe (left) to mild (right)
3D CT skull reconstruction illustrating MS of varying severity from severe (left) to mild (right). From: Fig 5 side 20 in the Doctoral thesis. Illustration: Niclas Löfgren

Results:
Study I found no significant differences in volume ratios between spring removal
and the 3-year follow-up.
Study II revealed that surgery reduced temporal deformity.
Study
III identified complication rates as follows: ClavienDindo, 7.2%; Leeds, 13.1%; Oxford, 8.1%.
Study IV found higher Caesarean section rates in children born with MS and sagittal synostosis (SS). MS was associated with higher rates of assisted reproductive technology (ART), breech, and pre-term birth.
Study V revealed maternal age, male sex, and breech as
independent risk factors for CS, whereas male sex, twins, and conception by ART were risk factors for MS.


Conclusions:
Relapse is not the cause of low frontal volume ratio, surgery eradicates two-
thirds of temporal deformity, Oxford grading is suitable for reporting complications in CF surgery, SS and MS children are at risk of higher rates of Caesarean sections, and we identified ART, twins and male sex as independent risk factors for MS.

MORE INFORMATION ABOUT THE DISSERTATION

Supervisor: Lars Kölby
Co-Supervisor:  Peter Tarnow och Giovanni Maltese
Opponent:  David Dunaway, University College London, London, UK
Examining Committee: Ann Thurin-Kjellberg, Andres Rodriguez Lorenzo och Magnus Tisell