Impact of Severity and Surgical Timing on Neurodevelopmental and Ophthalmologic Outcomes in Isolated Sagittal Craniosynostosis

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Authors

• Rachel Lee, Michigan State University College of Human Medicine Medical Student
• Caroline Baker, Pediatric Research Operations - Corewell Health West
• Theresa Nguyen, Michigan State University College of Human Medicine Medical Student
• Victoria Vespa, Michigan State University College of Human Medicine Medical Student
• Morgan Lentz, Plastic Surgery Resident - Corewell Health West
• John Girotto, Plastic Surgery - Corewell Health West
• Anna Carlson, Pediatrics - Craniofacial Surgery - Corewell Health West

Description

The influence of morphological severity and surgical timing on neurodevelopmental and ophthalmologic outcomes in sagittal craniosynostosis (CS) remains unclear. This study aimed to evaluate how cranial severity and age at surgery relate to these outcomes in patients with isolated sagittal CS.

A retrospective cohort study was conducted on 136 patients who underwent surgery for non-syndromic sagittal CS between 2012 and 2024. Morphological severity was quantified using cranial index measured by two independent graders (ICC = 0.952). Neurodevelopmental and ophthalmologic diagnoses were obtained from multidisciplinary clinic records. Odds ratios (ORs) with 95% confidence intervals (CIs) were derived from logistic regression models that assessed associations between cranial severity, surgical age, and each outcome. Continuous variables were non-normally distributed and reported as median [IQR].

Median age at surgery was 5.5 [4.33, 11.83] months and 76% of patients were male. Increasing surgical age was associated with higher odds of developmental delay (OR 1.04 [1.02-1.07], p=0.002) speech delay (OR 1.03 [1.00-1.05], p=0.03), ADHD (OR 1.04 [1.01-1.07], p=0.009), autism (OR 1.04 [1.01-1.08], p=0.01), fundoscopy abnormalities (OR 1.06 [1.03-1.11], p=0.001), optic nerve abnormalities (OR 1.04 [1.01-1.07], p=0.01), and strabismus (OR 1.03 [1.00-1.05], p=0.04). Associations with developmental delay (p=0.003), ADHD (p=0.01), autism (p=0.01), fundoscopy abnormalities (p=0.003), and optic nerve abnormalities (p=0.04) persisted after adjusting for severity. Severity alone was not predictive of any outcome.

Later surgical correction for sagittal CS was associated with increased odds of neurodevelopmental and ophthalmologic diagnoses, independent of cranial severity. These findings suggest clinical utility in early surgical intervention.

Publication Date

5-8-2026

Disciplines

Plastic Surgery

Recommended Citation

Lee R, Baker C, Nguyen T, Vespa V, Lentz M, Girotto J, Carlson A. Impact of severity and surgical timing on neurodevelopmental and ophthalmologic outcomes in isolated sagittal craniosynostosis. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1878