Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography
Objective: Suspicion of early anterior fontanel (AF) closure is a common reason for referral to a pediatric neurosurgeon because of the suspected increased risk of developing craniosynostosis (CS) in spite of the absence of evidence in the literature. The aim of this study was to analyze the associa...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-07-01
|
| Series: | Jornal de Pediatria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755721001479 |
| _version_ | 1797991365103058944 |
|---|---|
| author | Leopoldo Mandic Ferreira Furtado José Aloysio da Costa Val Filho Letícia Silveira Freitas Aieska Kellen Dantas dos Santos |
| author_facet | Leopoldo Mandic Ferreira Furtado José Aloysio da Costa Val Filho Letícia Silveira Freitas Aieska Kellen Dantas dos Santos |
| author_sort | Leopoldo Mandic Ferreira Furtado |
| collection | DOAJ |
| description | Objective: Suspicion of early anterior fontanel (AF) closure is a common reason for referral to a pediatric neurosurgeon because of the suspected increased risk of developing craniosynostosis (CS) in spite of the absence of evidence in the literature. The aim of this study was to analyze the association between AF closure and the diagnosis of non-syndromic CS in Brazilian children. Methods: An observational and case-cohort study was conducted to compare the incidence of closed AF between healthy children (group 1) and children diagnosed with non-syndromic CS (group 2) at a pediatric neurosurgery referral center. The accuracies of completely closed AF and diagnosis of CS were assessed. Results: High-resolution three-dimensional reconstruction computed tomography scans were obtained for 140 children aged < 13 months, of whom 62.9% were boys and 37.1% were girls (p < 0.001). The most common types of non-syndromic CS were trigonocephaly (34, 48%) and scaphocephaly (25, 35.7%). Closed fontanel (27, 38.6%) was observed in both groups, and a sensitivity of 36.1%, specificity of 72%, the positive predictive value of 59%, and negative predictive value of 51% were observed in the patients diagnosed with CS when AF closure occurred before the age of 6 months. Conclusion: The results of this comparative study of AF closure and CS diagnosis suggest that early AF closure does not imply a diagnosis of CS. Pediatricians should be aware of the risk of misdiagnosis of CS in cases with a widely open AF in spite of the presence of CS. |
| first_indexed | 2024-04-11T08:51:10Z |
| format | Article |
| id | doaj.art-ae11cd00bf9a4c76b03ffc9a2f1c54ba |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-11T08:51:10Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-ae11cd00bf9a4c76b03ffc9a2f1c54ba2022-12-22T04:33:35ZengElsevierJornal de Pediatria0021-75572022-07-01984413418Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomographyLeopoldo Mandic Ferreira Furtado0José Aloysio da Costa Val Filho1Letícia Silveira Freitas2Aieska Kellen Dantas dos Santos3Vila da Serra Hospital e Biocor Instituto, Departamento de Neurocirurgia Pediátrica, Nova Lima, MG, Brazil; Corresponding author.Vila da Serra Hospital e Biocor Instituto, Departamento de Neurocirurgia Pediátrica, Nova Lima, MG, BrazilVila da Serra Hospital, Departamento de Pediatria, Nova Lima, MG, BrazilVila da Serra Hospital e Biocor Instituto, Departamento de Neurocirurgia Pediátrica, Nova Lima, MG, BrazilObjective: Suspicion of early anterior fontanel (AF) closure is a common reason for referral to a pediatric neurosurgeon because of the suspected increased risk of developing craniosynostosis (CS) in spite of the absence of evidence in the literature. The aim of this study was to analyze the association between AF closure and the diagnosis of non-syndromic CS in Brazilian children. Methods: An observational and case-cohort study was conducted to compare the incidence of closed AF between healthy children (group 1) and children diagnosed with non-syndromic CS (group 2) at a pediatric neurosurgery referral center. The accuracies of completely closed AF and diagnosis of CS were assessed. Results: High-resolution three-dimensional reconstruction computed tomography scans were obtained for 140 children aged < 13 months, of whom 62.9% were boys and 37.1% were girls (p < 0.001). The most common types of non-syndromic CS were trigonocephaly (34, 48%) and scaphocephaly (25, 35.7%). Closed fontanel (27, 38.6%) was observed in both groups, and a sensitivity of 36.1%, specificity of 72%, the positive predictive value of 59%, and negative predictive value of 51% were observed in the patients diagnosed with CS when AF closure occurred before the age of 6 months. Conclusion: The results of this comparative study of AF closure and CS diagnosis suggest that early AF closure does not imply a diagnosis of CS. Pediatricians should be aware of the risk of misdiagnosis of CS in cases with a widely open AF in spite of the presence of CS.http://www.sciencedirect.com/science/article/pii/S0021755721001479Anterior fontanelComputed tomographySutureCraniosynostosisGrowth and development |
| spellingShingle | Leopoldo Mandic Ferreira Furtado José Aloysio da Costa Val Filho Letícia Silveira Freitas Aieska Kellen Dantas dos Santos Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography Jornal de Pediatria Anterior fontanel Computed tomography Suture Craniosynostosis Growth and development |
| title | Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography |
| title_full | Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography |
| title_fullStr | Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography |
| title_full_unstemmed | Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography |
| title_short | Anterior fontanelle closure and diagnosis of non-syndromic craniosynostosis: a comparative study using computed tomography |
| title_sort | anterior fontanelle closure and diagnosis of non syndromic craniosynostosis a comparative study using computed tomography |
| topic | Anterior fontanel Computed tomography Suture Craniosynostosis Growth and development |
| url | http://www.sciencedirect.com/science/article/pii/S0021755721001479 |
| work_keys_str_mv | AT leopoldomandicferreirafurtado anteriorfontanelleclosureanddiagnosisofnonsyndromiccraniosynostosisacomparativestudyusingcomputedtomography AT josealoysiodacostavalfilho anteriorfontanelleclosureanddiagnosisofnonsyndromiccraniosynostosisacomparativestudyusingcomputedtomography AT leticiasilveirafreitas anteriorfontanelleclosureanddiagnosisofnonsyndromiccraniosynostosisacomparativestudyusingcomputedtomography AT aieskakellendantasdossantos anteriorfontanelleclosureanddiagnosisofnonsyndromiccraniosynostosisacomparativestudyusingcomputedtomography |