ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
166
OPTIMIZATION OF SURGICAL STRATEGY FOR
CRANIOSYNOSTOSIS IN CHILDREN BASED ON PREOPERATIVE
MSCT DIAGNOSTICS
Nazarova L.A.
National Children's Medical Center" Children's Neurosurgery Department,
Parkent Street, 294, Tashkent, Uzbekistan, 1001711
https://doi.org/10.5281/zenodo.15261140
Abstract
This study proposes an optimized surgical approach for craniosynostosis in
children using preoperative multislice computed tomography (MSCT). A total of
150 retrospective cases and a pilot group of 80 patients were analyzed using
tailored pediatric MSCT protocols. Morphometric parameters were compared
with
international
craniofacial
databases.
Clinical,
neurological,
ophthalmological, and cosmetic outcomes were evaluated. Optimized protocols
led to a radiation dose reduction of 30–40%. Advanced statistical methods,
including t-test, ANOVA, and Bayesian network meta-analysis, revealed factors
associated with better surgical outcomes. The proposed strategy significantly
improved preoperative planning, surgical precision, and postoperative
rehabilitation in pediatric patients.
Keywords:
Craniosynostosis, children, MSCT, morphometry, 3D reconstruction,
radiation dose, craniofacial surgery, Bayesian meta-analysis.
Relevance
Craniosynostosis affects approximately 1 in 2,000 live births, requiring
early diagnosis and intervention to avoid intracranial hypertension and severe
craniofacial deformities. MSCT with 3D reconstruction is the diagnostic gold
standard, but the pediatric population demands a careful balance between
image quality and radiation safety. Over 80% of centers worldwide lack
standardized protocols for pediatric craniofacial imaging. This study addresses
this gap by developing optimized MSCT protocols with dose reductions of up to
40%, enabling detailed anatomical assessment with minimized risk.
Incorporating morphometric analysis, clinical outcomes, and long-term follow-
up, the study proposes a standardized, safe, and effective workflow. The
relevance lies in integrating diagnostic accuracy, surgical planning, and
functional recovery into a unified strategy, potentially impacting national and
international standards of care for children with craniosynostosis.
Objective:
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
167
To develop and validate an optimized surgical strategy for craniosynostosis
in children using preoperative MSCT imaging, with a focus on diagnostic
accuracy, radiation safety, and clinical outcomes.
Materials and Methods
The study included 150 retrospective cases (ages 3–18 months) and a pilot
group of 80 children prospectively examined. Inclusion criteria: MSCT data,
confirmed diagnosis, and surgical treatment. Exclusion: missing imaging/clinical
data or severe comorbidities. MSCT with 0.5 mm slices and 3D volume rendering
was used. MRI was added in 22% of syndromic cases. Morphometric analysis
included cranial index, cephalic asymmetry, and skull angles, compared with
four international anthropometric databases. Clinical data covered surgical
technique, length of stay, complications, and neurological development.
Radiation dose parameters (kV, mA) were optimized. Statistical analysis
included t-test, ANOVA, and Bayesian network meta-analysis (n = 230).
Results
Optimized MSCT protocols led to radiation dose reductions of 32–38%
(mean DLP: 245 vs. 378 mGy·cm). Morphometric deviations ≥15% from normal
were found in 82% of patients. Early surgical intervention (<6 months) resulted
in significantly better outcomes (p < 0.01) across neurological and cosmetic
domains. The pilot group demonstrated 96.3% technical success, and
postoperative complication rate decreased to 4.2%. Bayesian meta-analysis
showed that frontal-orbital advancement combined with morphometric
planning had the highest probability of optimal outcomes (P = 0.86). Enhanced
protocols improved interdisciplinary collaboration and parental satisfaction
scores by 23%.
Conclusion
Tailored preoperative MSCT with low-dose protocols enhances the safety
and accuracy of craniosynostosis surgery in children. The study demonstrates
that morphometric-guided planning and early intervention lead to better
functional, neurological, and aesthetic results. Radiation exposure was reduced
by up to 40%, aligning with ALARA (As Low As Reasonably Achievable)
principles. Bayesian network meta-analysis confirmed the superiority of
individualized surgical techniques over conventional methods. These findings
support the integration of standardized MSCT protocols into clinical practice
and can serve as a model for pediatric craniofacial centers globally, improving
both short- and long-term treatment outcomes.
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
168
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