RESEARCH QUESTION Is the effectiveness of conservative policy comparable to that of surgery in children with trigonocephaly, with regard to clinical outcomes and psychosocial functioning, stress for parents, and costs? DESIGN Observational cohort study in children, aged 0 to 8 years old, with trigonocephaly, excluding metopic ridging (physiologic early closure of metopic suture), treated conservatively or surgically.
OUTCOME MEASURES Primary: Head growth decline, indicating raised intracranial pressure Secondary: fundoscopy, cognition, behavior, refraction and vision, forehead shape, quality of life, posttraumatic stress, decisional conflict, costs.
diagnosis of trigonocephaly
metopic ridge (physiologic early closure of metopic suture)
Children with mild, moderate or severe trigonocephaly, between 0 and 8 years of age, excluding metopic ridge (i.e. physiologic early closure of metopic suture).
Cohort
Prospective
craniofacial surgery
Procedure/SurgerySurgical treatment, either stripcraniectomy or fronto-orbital advancement
Head growth
Annual measurement of head circumference in SD for gender and age. Decline in head growth may indicate raised intracranial pressure
fundoscopy
Annual screening for presence of papilledema as sign of raised intracranial pressure
Cognition and behavior
Validated tests for cognition and behavior of the child
refraction and vision
tests taken by orthoptist
forehead shape
3D photos (objective) and VAS score by parents (subjective) to grade the forehead shape
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Erasmus Medical Center
Lead sponsor
LAPOSA
Collaborator
IJsselland Hospital
Collaborator
Sint Franciscus Gasthuis
Collaborator
