Functional outcome after surgery for trigonocephaly

Abstract

The long-term mental outcome of 76 children operated on for trigonocephaly was assessed, and the factors influencing the prognosis were studied. Final assessment of mental development was made on children who were more than 3 years old and was based on the occurrence of behavioral disturbances, learning disability, and school difficulties, and on intellectual efficiency. Children were graded into three groups: no abnormality, mild abnormalities but with normal social function, and grossly abnormal. Preoperative computed tomography scans were used to measure the severity of the frontal stenosis and to identify associated intracranial abnormalities, such as agenesis of the corpus callosum, dilatation of the subdural spaces, or hydrocephalus. Associated extracranial malformations and associated family cases were also noted. Lastly, the family setting was studied. Overall, 31.6 percent of patients had evidence of some degree of trouble. Several correlations were identified: mental development was worse when the frontal stenosis was severe, when cranial reconstruction was performed after 1 year of age, and when there were associated extracranial malformations. In addition, the family environment was found to have a major influence, but the presence of intracranial abnormalities did not correlate with mental development.