Skip to main content
Erschienen in: Child's Nervous System 6/2013

01.06.2013 | Original Paper

Longitudinal study of the neurodevelopmental characteristics of treated and untreated nonsyndromic craniosynostosis in infancy

verfasst von: Annette C. Da Costa, Vicki A. Anderson, Anthony D. Holmes, Patrick Lo, Alison C. Wray, David K. Chong, Andrew L. Greensmith, John G. Meara

Erschienen in: Child's Nervous System | Ausgabe 6/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Nonsyndromic craniosynostosis (NSC) are a group of congenital disorders sharing premature fusion of one or more of the cranial sutures that restricts and distorts growth of the skull and underlying brain. This study examined the neurodevelopmental sequelae of NSC both prior to and following reconstructive cranial surgery.

Methods

Sixty-four consecutive referrals with mixed forms of untreated NSC aged 4 to 16 months (M = 8.9, SD = 2.9) comprised the pre-operative cohort. Forty-four of these patients aged 6 to 32 months (M = 21.2, SD = 4.5) underwent post-operative developmental evaluation. Neurodevelopmental function was assessed with the mental (Mental Development Index) and motor (Psychomotor Development Index) scales of the Bayley Scales of Infant Development—2nd edition.

Results

Children with untreated NSC displayed significantly lower mental (M = 97.5) and motor (M = 87.7) scores than normative expectations, with the distribution of scores also differing significantly from the normative distribution. Post-operatively, children continued to display significantly lower mental (M = 89.5) and motor (M = 88.0) abilities, with mental abilities falling significantly lower than pre-operative levels. An increased prevalence of severe motor delay was found, and no child displayed accelerated development. Subgroup comparisons revealed no differences in mental or motor skills between the primary diagnostic subtypes (sagittal and metopic synostosis) both prior to and following corrective surgery.

Conclusions

NSC is associated with an increased incidence of developmental delay in both treated and untreated conditions. Timing of surgery appears unrelated to developmental outcome.
Literatur
1.
Zurück zum Zitat Cohen MJ, MacLean R (2000) Craniosynostosis: diagnosis, evaluation, and management. Oxford University Press, New York Cohen MJ, MacLean R (2000) Craniosynostosis: diagnosis, evaluation, and management. Oxford University Press, New York
2.
Zurück zum Zitat Singer S, Bower C, Southall P, Goldblatt J (1999) Craniosynostosis in Western Australia, 1990–1994: a population-based study. Am J Med Genet 83:382–387PubMedCrossRef Singer S, Bower C, Southall P, Goldblatt J (1999) Craniosynostosis in Western Australia, 1990–1994: a population-based study. Am J Med Genet 83:382–387PubMedCrossRef
3.
Zurück zum Zitat Gault D, Renier D, Marchac D, Jones B (1992) Intracranial pressure and intracranial volume in children with craniosynostosis. Plast Reconstr Surg 90:377–381PubMedCrossRef Gault D, Renier D, Marchac D, Jones B (1992) Intracranial pressure and intracranial volume in children with craniosynostosis. Plast Reconstr Surg 90:377–381PubMedCrossRef
4.
Zurück zum Zitat Siddiqi S, Posnick J, Buncic R, Humphreys R, Hoffman H, Drake J, Rutka J (1995) The detection and management of intracranial hypertension after initial suture release and decompression for craniofacial dysostosis syndromes. Neurosurgery 36:703–708, discussion 708–709PubMedCrossRef Siddiqi S, Posnick J, Buncic R, Humphreys R, Hoffman H, Drake J, Rutka J (1995) The detection and management of intracranial hypertension after initial suture release and decompression for craniofacial dysostosis syndromes. Neurosurgery 36:703–708, discussion 708–709PubMedCrossRef
5.
Zurück zum Zitat Thompson D, Harkness W, Jones B, Gonsalez S, Andar U, Hayward R (1995) Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management. Childs Nerv Syst 11:269–275PubMedCrossRef Thompson D, Harkness W, Jones B, Gonsalez S, Andar U, Hayward R (1995) Subdural intracranial pressure monitoring in craniosynostosis: its role in surgical management. Childs Nerv Syst 11:269–275PubMedCrossRef
6.
Zurück zum Zitat Renier D, Lajeunie E, Arnaud E, Marchac D (2000) Management of craniosynostosis. Childs Nerv Syst 16:645–658PubMedCrossRef Renier D, Lajeunie E, Arnaud E, Marchac D (2000) Management of craniosynostosis. Childs Nerv Syst 16:645–658PubMedCrossRef
7.
Zurück zum Zitat Aldridge K, Kane A, Marsh J, Panchal J, Boyadjiev S, Yan P, Govier D, Ahmad W, Richtsmeier J (2005) Brain morphology in nonsyndromic unicoronal craniosynostosis. Anat Rec A Discov Mol Cell Evol Biol 285:690–698PubMed Aldridge K, Kane A, Marsh J, Panchal J, Boyadjiev S, Yan P, Govier D, Ahmad W, Richtsmeier J (2005) Brain morphology in nonsyndromic unicoronal craniosynostosis. Anat Rec A Discov Mol Cell Evol Biol 285:690–698PubMed
8.
Zurück zum Zitat Aldridge K, Kane A, Marsh J, Yan P, Govier D, Richtsmeier J (2005) Relationship of brain and skull in pre- and postoperative sagittal synostosis. J Anat 206:373–385PubMedCrossRef Aldridge K, Kane A, Marsh J, Yan P, Govier D, Richtsmeier J (2005) Relationship of brain and skull in pre- and postoperative sagittal synostosis. J Anat 206:373–385PubMedCrossRef
9.
Zurück zum Zitat Da Costa A, Anderson V, Savarirayan R, Wrennall J, Chong D, Holmes A, Greensmith A, Meara JG (2012) Neurodevelopmental functioning of infants with untreated single-suture craniosynostosis during early infancy. Childs Nerv Syst 28:869–877PubMedCrossRef Da Costa A, Anderson V, Savarirayan R, Wrennall J, Chong D, Holmes A, Greensmith A, Meara JG (2012) Neurodevelopmental functioning of infants with untreated single-suture craniosynostosis during early infancy. Childs Nerv Syst 28:869–877PubMedCrossRef
10.
Zurück zum Zitat Arnaud E, Renier D, Marchac D (1995) Prognosis for mental function in scaphocephaly. Neurosurgery 83:476–479CrossRef Arnaud E, Renier D, Marchac D (1995) Prognosis for mental function in scaphocephaly. Neurosurgery 83:476–479CrossRef
11.
Zurück zum Zitat Kapp-Simon K, Figueroa A, Jocher C, Schafer M (1993) Longitudinal assessment of mental development in infants with nonsyndromic craniosynostosis with and without cranial release and reconstruction. Plast Reconstr Surg 92:831–839, discussion 840–831PubMed Kapp-Simon K, Figueroa A, Jocher C, Schafer M (1993) Longitudinal assessment of mental development in infants with nonsyndromic craniosynostosis with and without cranial release and reconstruction. Plast Reconstr Surg 92:831–839, discussion 840–831PubMed
12.
Zurück zum Zitat Speltz M, Endriga M, Mouradian W (1997) Presurgical and postsurgical mental and psychomotor development of infants with sagittal synostosis. Cleft Palate Craniofac J 34:374–379PubMedCrossRef Speltz M, Endriga M, Mouradian W (1997) Presurgical and postsurgical mental and psychomotor development of infants with sagittal synostosis. Cleft Palate Craniofac J 34:374–379PubMedCrossRef
13.
Zurück zum Zitat Warschausky S, Angobaldo J, Kewman D, Buchman S, Muraszko K, Azengart A (2005) Early development of infants with untreated metopic craniosynostosis. Plast Reconstr Surg 115:1518–1523PubMedCrossRef Warschausky S, Angobaldo J, Kewman D, Buchman S, Muraszko K, Azengart A (2005) Early development of infants with untreated metopic craniosynostosis. Plast Reconstr Surg 115:1518–1523PubMedCrossRef
14.
Zurück zum Zitat Cohen S, Cho D, Nichols S, Simms C, Cross K, Burstein F (2004) American society of maxillofacial surgeons outcome study: preoperative and postoperative neurodevelopmental findings in single-suture craniosynostosis. Plast Reconstr Surg 15:841–847, discussion 848–849 Cohen S, Cho D, Nichols S, Simms C, Cross K, Burstein F (2004) American society of maxillofacial surgeons outcome study: preoperative and postoperative neurodevelopmental findings in single-suture craniosynostosis. Plast Reconstr Surg 15:841–847, discussion 848–849
15.
Zurück zum Zitat Ruiz-Correa S, Starr J, Lin H, Kapp-Simon K, Cunningham M, Speltz M (2007) Severity of skull malformation is unrelated to presurgery neurobehavioral status of infants with sagittal synostosis. Cleft Palate Craniofac J 44:548–554PubMedCrossRef Ruiz-Correa S, Starr J, Lin H, Kapp-Simon K, Cunningham M, Speltz M (2007) Severity of skull malformation is unrelated to presurgery neurobehavioral status of infants with sagittal synostosis. Cleft Palate Craniofac J 44:548–554PubMedCrossRef
16.
Zurück zum Zitat Kapp-Simon K, Leroux B, Speltz M (2005) Multi-site study of infants with single-suture craniosynostosis: preliminary report of pre-surgery development. Cleft Palate Craniofac J 42:377–384PubMedCrossRef Kapp-Simon K, Leroux B, Speltz M (2005) Multi-site study of infants with single-suture craniosynostosis: preliminary report of pre-surgery development. Cleft Palate Craniofac J 42:377–384PubMedCrossRef
17.
Zurück zum Zitat Panchal J, Amirsheybani H, Gurwitch R, Cook V, Francei P, Neas B, Levine N (2001) Neurodevelopment in children with single-suture craniosynostosis and plagiocephaly without synostosis. Plast Reconstr Surg 108:1492–1498PubMedCrossRef Panchal J, Amirsheybani H, Gurwitch R, Cook V, Francei P, Neas B, Levine N (2001) Neurodevelopment in children with single-suture craniosynostosis and plagiocephaly without synostosis. Plast Reconstr Surg 108:1492–1498PubMedCrossRef
18.
Zurück zum Zitat Bellew M, Chumas P, Mueller R, Liddington M, Russell J (2005) Pre- and postoperative developmental attainment in sagittal synostosis. Arch Dis Child Apr 90:346–350CrossRef Bellew M, Chumas P, Mueller R, Liddington M, Russell J (2005) Pre- and postoperative developmental attainment in sagittal synostosis. Arch Dis Child Apr 90:346–350CrossRef
19.
Zurück zum Zitat Gewalli F, Guimarães-Ferreira J, Sahlin P, Emanuelsson I, Horneman G, Stephensen H, Lauritzen C (2001) Mental development after modified pi procedure: dynamic cranioplasty for sagittal synostosis. Ann Plast Surg 46:415–420PubMedCrossRef Gewalli F, Guimarães-Ferreira J, Sahlin P, Emanuelsson I, Horneman G, Stephensen H, Lauritzen C (2001) Mental development after modified pi procedure: dynamic cranioplasty for sagittal synostosis. Ann Plast Surg 46:415–420PubMedCrossRef
20.
Zurück zum Zitat Starr J, Kapp-Simon K, Cloonan Y, Collett B, Cradock M, Buono L, Cunningham M, Speltz M (2007) Presurgical and postsurgical assessment of the neurodevelopment of infants with single-suture craniosynostosis: comparison with controls. J Neurosurg 107(2 Suppl):103–110PubMed Starr J, Kapp-Simon K, Cloonan Y, Collett B, Cradock M, Buono L, Cunningham M, Speltz M (2007) Presurgical and postsurgical assessment of the neurodevelopment of infants with single-suture craniosynostosis: comparison with controls. J Neurosurg 107(2 Suppl):103–110PubMed
21.
Zurück zum Zitat de Leon M, Speltz M, Cunningham M (2000) Does sagittal synostosis adversely affect early psychological development? In: Presented at the annual meeting of the UW Star-Bridges Program, Seattle de Leon M, Speltz M, Cunningham M (2000) Does sagittal synostosis adversely affect early psychological development? In: Presented at the annual meeting of the UW Star-Bridges Program, Seattle
22.
Zurück zum Zitat Toth K, Collett B, Kapp-Simon K, Cloonan Y, Gaither R, Cradock M, Buono L, Cunningham M, Dawson G, Starr J, Speltz M (2007) Memory and response inhibition in young children with single-suture craniosynostosis. Child Neuropsychol 26:1–14 Toth K, Collett B, Kapp-Simon K, Cloonan Y, Gaither R, Cradock M, Buono L, Cunningham M, Dawson G, Starr J, Speltz M (2007) Memory and response inhibition in young children with single-suture craniosynostosis. Child Neuropsychol 26:1–14
23.
Zurück zum Zitat Arnaud E, Meneses P, Lajeunie E, Thorne J, Marchac D, Renier D (2002) Postoperative mental and morphological outcome for nonsyndromic brachycephaly. Plast Reconstr Surg 110:6–12PubMedCrossRef Arnaud E, Meneses P, Lajeunie E, Thorne J, Marchac D, Renier D (2002) Postoperative mental and morphological outcome for nonsyndromic brachycephaly. Plast Reconstr Surg 110:6–12PubMedCrossRef
24.
Zurück zum Zitat Bottero L, Lajeunie E, Arnaud E, Marchac D, Renier D (1998) Functional outcome after surgery for trigonocephaly. Plast Reconstr Surg 102:952–958, discussion 959–960PubMed Bottero L, Lajeunie E, Arnaud E, Marchac D, Renier D (1998) Functional outcome after surgery for trigonocephaly. Plast Reconstr Surg 102:952–958, discussion 959–960PubMed
25.
Zurück zum Zitat De Moura DR, Costa JC, Santos IS, Barros AJD, Matijasevich A, Halpern R, Dumith S, Karam S, Barros FC (2010) Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort. Paediatr Perinat Epidemiol 24:211–221PubMedCrossRef De Moura DR, Costa JC, Santos IS, Barros AJD, Matijasevich A, Halpern R, Dumith S, Karam S, Barros FC (2010) Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort. Paediatr Perinat Epidemiol 24:211–221PubMedCrossRef
26.
Zurück zum Zitat Greensmith AL, Holmes AD, Lo P, Maixner W, Heggie AA, Meara JG (2008) Complete correction of severe scaphocephaly: the Melbourne method of total vault remodeling. Plast Reconstr Surg 121:1300–1310, 1310.1097/1301.prs.0000304592.0000356498.d0000304596PubMedCrossRef Greensmith AL, Holmes AD, Lo P, Maixner W, Heggie AA, Meara JG (2008) Complete correction of severe scaphocephaly: the Melbourne method of total vault remodeling. Plast Reconstr Surg 121:1300–1310, 1310.1097/1301.prs.0000304592.0000356498.d0000304596PubMedCrossRef
27.
Zurück zum Zitat Bayley N (1993) Bayley Scales of Infant Development (2nd edition) (Bayley-II). Psychological Corporation, San Antonio Bayley N (1993) Bayley Scales of Infant Development (2nd edition) (Bayley-II). Psychological Corporation, San Antonio
28.
Zurück zum Zitat Daniel A (1983) Power, privilege and prestige: occupations in Australia. Longman-Cheshire, Melbourne Daniel A (1983) Power, privilege and prestige: occupations in Australia. Longman-Cheshire, Melbourne
29.
Zurück zum Zitat Speltz ML, Kapp-Simon K, Collett B, Keich Y, Gaither R, Cradock MM, Buono L, Cunningham ML (2007) Neurodevelopment of infants with single-suture craniosynostosis: presurgery comparisons with case-matched controls. Plast Reconstr Surg 119:1874–1881PubMedCrossRef Speltz ML, Kapp-Simon K, Collett B, Keich Y, Gaither R, Cradock MM, Buono L, Cunningham ML (2007) Neurodevelopment of infants with single-suture craniosynostosis: presurgery comparisons with case-matched controls. Plast Reconstr Surg 119:1874–1881PubMedCrossRef
30.
Zurück zum Zitat Korpilahti P, Saarinen P, Hukki J (2011) Deficient language acquisition in children with single suture craniosynostosis and deformational posterior plagiocephaly. Childs Nervous System 28:419–425 Korpilahti P, Saarinen P, Hukki J (2011) Deficient language acquisition in children with single suture craniosynostosis and deformational posterior plagiocephaly. Childs Nervous System 28:419–425
31.
Zurück zum Zitat Shipster C, Hearst D, Somerville A, Stackhouse J, Hayward R, Wade A (2003) Speech, language and cognitive development in children with isolated sagittal synostosis. Dev Med Child Neurol 45:34–43PubMedCrossRef Shipster C, Hearst D, Somerville A, Stackhouse J, Hayward R, Wade A (2003) Speech, language and cognitive development in children with isolated sagittal synostosis. Dev Med Child Neurol 45:34–43PubMedCrossRef
32.
Zurück zum Zitat Siegel L (1989) IQ is irrelevant to the definition of learning disabilities. J Learn Disabil 22:468–478CrossRef Siegel L (1989) IQ is irrelevant to the definition of learning disabilities. J Learn Disabil 22:468–478CrossRef
33.
Zurück zum Zitat Diamond A (2000) Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Dev 71:44–56PubMedCrossRef Diamond A (2000) Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Dev 71:44–56PubMedCrossRef
34.
Zurück zum Zitat Fuller S, Nord AS, Gerdes M, Wernovsky G, Jarvik GP, Bernbaum J, Zackai E, Gaynor JW (2009) Predictors of impaired neurodevelopmental outcomes at one year of age after infant cardiac surgery. Eur J Cardiothorac Surg 36:40–48PubMedCrossRef Fuller S, Nord AS, Gerdes M, Wernovsky G, Jarvik GP, Bernbaum J, Zackai E, Gaynor JW (2009) Predictors of impaired neurodevelopmental outcomes at one year of age after infant cardiac surgery. Eur J Cardiothorac Surg 36:40–48PubMedCrossRef
35.
Zurück zum Zitat Tabbutt S, Nord AS, Jarvik GP, Bernbaum J, Wernovsky G, Gerdes M, Zackai E, Clancy RR, Nicolson SC, Spray TL, Gaynor JW (2008) Neurodevelopmental outcomes after staged palliation for hypoplastic left heart syndrome. Pediatrics 121:476–483PubMedCrossRef Tabbutt S, Nord AS, Jarvik GP, Bernbaum J, Wernovsky G, Gerdes M, Zackai E, Clancy RR, Nicolson SC, Spray TL, Gaynor JW (2008) Neurodevelopmental outcomes after staged palliation for hypoplastic left heart syndrome. Pediatrics 121:476–483PubMedCrossRef
36.
Zurück zum Zitat Aldridge K, Marsh J, Govier D, Richtsmeier J (2002) Central nervous system phenotypes in craniosynostosis. J Anat 201:31–39PubMedCrossRef Aldridge K, Marsh J, Govier D, Richtsmeier J (2002) Central nervous system phenotypes in craniosynostosis. J Anat 201:31–39PubMedCrossRef
37.
Zurück zum Zitat Anderson V, Bond L, Catroppa C, Grimwood K, Keir E, Nolan T (1997) Childhood bacterial meningitis: impact of age at illness and medical complications on long term outcome. J Int Neuropsychol Soc 3:147–158PubMed Anderson V, Bond L, Catroppa C, Grimwood K, Keir E, Nolan T (1997) Childhood bacterial meningitis: impact of age at illness and medical complications on long term outcome. J Int Neuropsychol Soc 3:147–158PubMed
38.
Zurück zum Zitat Franco S, Cornelius V, Andrews B (1992) Long-term outcome of neonatal meningitis. Am J Dis Childhood 146:567–571 Franco S, Cornelius V, Andrews B (1992) Long-term outcome of neonatal meningitis. Am J Dis Childhood 146:567–571
39.
Zurück zum Zitat Grimwood K, Nolan T, Bond L, Anderson V, Catroppa C, Keir E (1996) Risk factors for adverse outcomes of bacterial meningitis. J Pediatr Child Health 32:457–462CrossRef Grimwood K, Nolan T, Bond L, Anderson V, Catroppa C, Keir E (1996) Risk factors for adverse outcomes of bacterial meningitis. J Pediatr Child Health 32:457–462CrossRef
40.
Zurück zum Zitat Wright M, Nolan T (1994) Impact of cyanotic heart disease on school performance. Arch Dis Childhood 71:64–70CrossRef Wright M, Nolan T (1994) Impact of cyanotic heart disease on school performance. Arch Dis Childhood 71:64–70CrossRef
41.
Zurück zum Zitat Anderson V, Smibert E, Ekert H, Godber T (1994) Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy. Arch Dis Childhood 70:476–483CrossRef Anderson V, Smibert E, Ekert H, Godber T (1994) Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy. Arch Dis Childhood 70:476–483CrossRef
42.
Zurück zum Zitat Rubinstein C, Varni J, Katz E (1990) Cognitive functioning in long-term survivors of childhood leukemia: a prospective analysis. Dev Behav Pediatr 11:301–305 Rubinstein C, Varni J, Katz E (1990) Cognitive functioning in long-term survivors of childhood leukemia: a prospective analysis. Dev Behav Pediatr 11:301–305
43.
Zurück zum Zitat Duchowny M (1996) Identification of surgical candidates and timing of operation: an overview. In: Wyllie E (ed) The treatment of epilepsy: principles and practice, 2nd edn. Williams & Wilkins, Baltimore, pp 967–975 Duchowny M (1996) Identification of surgical candidates and timing of operation: an overview. In: Wyllie E (ed) The treatment of epilepsy: principles and practice, 2nd edn. Williams & Wilkins, Baltimore, pp 967–975
44.
Zurück zum Zitat Naumann H, Haberkern C, Starr J, Kapp-Simon K, Hopper R, Speltz M (2012) Duration of exposure to cranial vault surgery: associations with neurodevelopment among children with single-suture synostosis. Paediatr Anaesth 22:1053–1061CrossRef Naumann H, Haberkern C, Starr J, Kapp-Simon K, Hopper R, Speltz M (2012) Duration of exposure to cranial vault surgery: associations with neurodevelopment among children with single-suture synostosis. Paediatr Anaesth 22:1053–1061CrossRef
Metadaten
Titel
Longitudinal study of the neurodevelopmental characteristics of treated and untreated nonsyndromic craniosynostosis in infancy
verfasst von
Annette C. Da Costa
Vicki A. Anderson
Anthony D. Holmes
Patrick Lo
Alison C. Wray
David K. Chong
Andrew L. Greensmith
John G. Meara
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
Child's Nervous System / Ausgabe 6/2013
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-012-2017-0

Weitere Artikel der Ausgabe 6/2013

Child's Nervous System 6/2013 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.