{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T02:01:23Z","timestamp":1788141683945,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study compares perioperative outcomes of three operative approaches for metopic craniosynostosis: spring-assisted cranioplasty (SAC), strip craniectomy (SC), and fronto-orbital advancement (FOA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single-institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Patients with metopic craniosynostosis treated 2021 to 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>SC, FOA, SAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Perioperative data including blood loss, anesthesia duration, operative duration, hospital length of stay. For SAC, metrics for placement and removal were combined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six patients underwent SAC, seven SC, and seven FOA at 4.77 (\u00b11.22), 3.42 (\u00b1.46), and 11.38 (\u00b13.65) months, respectively. FOA exhibited increased blood loss (median [IQR]; 200\u2005mL [162.5, 250]), anesthesia time (328.86\u2005min \u00b149.65) and operative time (230.86\u2005min \u00b145.38) compared to SC (40 [20, 57.5];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.005; 153.29\u2009\u00b1\u200932.2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001; 70.43\u2009\u00b1\u200920.11;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and SAC (50 [40,75];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.012; 254.17\u2009\u00b1\u200932.81;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.012; 131\u2009\u00b1\u200924.5;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SAC for metopic craniosynostosis has lower blood loss, shorter operative time, and shorter anesthesia time in comparison to FOA. Total hospital stay duration required for SAC (including spring placement and removal procedures) is similar to FOA and greater than SC. Perioperative metrics for SAC are favorable or comparable relative to current standard-of-care procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251403083","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T15:07:58Z","timestamp":1764860878000},"page":"370-375","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Spring-Assisted Cranioplasty for Metopic Craniosynostosis: Perioperative Metrics in Comparison to Fronto-Orbital Advancement and Strip Craniectomy"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0063-5704","authenticated-orcid":false,"given":"Rachel S.","family":"Lee","sequence":"first","affiliation":[{"name":"Michigan State University College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Girian","sequence":"additional","affiliation":[{"name":"Helen DeVos Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Baker","sequence":"additional","affiliation":[{"name":"Helen DeVos Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Madura","sequence":"additional","affiliation":[{"name":"Helen DeVos Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Girotto","sequence":"additional","affiliation":[{"name":"Helen DeVos Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Petronio","sequence":"additional","affiliation":[{"name":"Helen DeVos Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8634-426X","authenticated-orcid":false,"given":"Anna","family":"Rose Carlson","sequence":"additional","affiliation":[{"name":"Helen DeVos Children's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-012-1803-z"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3109\/2000656X.2013.812967"},{"key":"e_1_3_3_4_2","unstructured":"Wood BC Mendoza CS Oh AK Myers E Safdar N Linguraru MG Rogers GF . What\u2019s in a Name? Accurately Diagnosing Metopic\u2026\u202f: Plastic and Reconstructive Surgery. Accessed July 6 2025. https:\/\/journals.lww.com\/plasreconsurg\/fulltext\/2016\/01000\/what_s_in_a_name__accurately_diagnosing_metopic.38.aspx."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001866"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2024.09.001"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007931"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3171\/2021.1.FOCVID2060"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665620966521"},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","unstructured":"Valetopoulou A Constantinides M Eccles S Ong J Hayward R Dunaway D Jeelani N James G Silva A.Endoscopic strip craniectomy with molding helmet therapy versus spring-assisted cranioplasty for nonsyndromic single-suture sagittal craniosynostosis: a systematic review. 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