Workshop 4

Mar 04, 2017 by AAPOS editor in  Workshop

Interdisciplinary Management of Children with Craniofacial Malformations (Craniosynostosis)

Meghan Flemmons, MD; Christopher Bonfield, MD; Linda Dagi, MD; Jane Edmond, MD; Kevin Kelly, MD, DDS

Purpose/Relevance:  In addition to strabismus and high refractive error, increased intracranial pressure and papilledema are frequently observed co-morbidities in children with craniosynostosis. The purpose of this workshop is to discuss monitoring and intervention for these patients.

Target Audience:  Pediatric ophthalmologists, trainees

Current Practice:  Papilledema in patients with craniosynostosis can lead to permanent vision loss. Monitoring of afferent visual function, optic nerve changes, and determining if intracranial pressure is elevated can be challenging in craniosynostosis patients and requires a multidisciplinary approach.

Best Practice:  This multidisciplinary workshop will address diagnosis and management of children with craniosynostosis through didactics and case presentations. The panel includes a pediatric neuro-ophthalmologist, a pediatric neurosurgeon and a pediatric craniofacial surgeon as well as a strabismus surgeon with expertise in craniofacial syndromes.

Expected Outcomes:  The audience will gain knowledge in management of increased intracranial pressure in craniosynostosis patients, including treatment options, timing of treatment, and monitoring intracranial pressure, visual function, and optic nerve appearance.

Format:  Didactics and case presentation by panelists with audience participation encouraged through questions and personal experience.

Summary:  Craniosynostosis is associated with increased intracranial pressure and papilledema which can result in vision loss.  This course will provide details of current management strategies for these complications which will assist the pediatric ophthalmologist in providing care for these children as one of the members of a multidisciplinary team.

References:  1. Iyengar RJ, Klinge PM, Chen WS, Boxerman JL, Sullivan SR, Taylor HO. Management of craniosynostosis at an advanced age: controversies, clinical findings,and surgical treatment. J Craniofac Surg. 2016 Jul;27(5):e435-41.
2. Dagi LR, Tiedemann LM, Heidary G, Robson CD, Hall AM, Zurakowski D. Using spectral-domain optical coherence tomography to detect optic neuropathy in patients with craniosynostosis. J AAPOS. 2014 Dec;18(6):543-9.

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