Marcos Devanir Silva da Costa1,2, Jardel Mendonça Nicacio3,4, Patricia Alessandra Dastoli3,4, Italo Capraro Suriano3,4, Stéphanno Gomes Pereira Sarmento5,6, Mauricio Mendes Barbosa5,6, Antonio Fernandes Moron5,6, Sergio Cavalheiro3,4. 1. Department of Neurosurgery, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil. marcoscostaneuro@gmail.com. 2. Department of Fetal Neurosurgery, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil. marcoscostaneuro@gmail.com. 3. Department of Neurosurgery, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil. 4. Department of Fetal Neurosurgery, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil. 5. Department of Obstetrics, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil. 6. Department of Fetal Medicine, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil.
Abstract
PURPOSE: The aim of this study was to analyze the skull base anatomy of patients who underwent intrauterine or postnatal myelomeningocele repair and to determine its relationship with hydrocephalus. METHODS: This was a retrospective cross-sectional study that analyzed three groups: the postnatal group, 57 patients who underwent myelomeningocele repair up to 48 h after birth; the fetal group, 70 patients who underwent myelomeningocele repair between 19 and 27 weeks of gestation; and a control group (65). We compared the rate of hydrocephalus treatment, the clivus-supraocciput angle (CSA), and the Welcher angle. RESULTS: The mean CSA in the fetal group was 87.6°, and the postnatal group was significantly different at 78.3° (p < 0.0001). The control group (89.1°) was significantly different from the postnatal group but not from the fetal group. The mean Welcher angle was not significantly different between the groups. There was an 8.5% rate of surgical treatment for hydrocephalus in the fetal group, compared with 73.6% in the postnatal group. CONCLUSIONS: The CSA in the fetal group was larger than that in the postnatal group, which may explain the decrease in the prevalence of hydrocephalus in the fetal group.
PURPOSE: The aim of this study was to analyze the skull base anatomy of patients who underwent intrauterine or postnatal myelomeningocele repair and to determine its relationship with hydrocephalus. METHODS: This was a retrospective cross-sectional study that analyzed three groups: the postnatal group, 57 patients who underwent myelomeningocele repair up to 48 h after birth; the fetal group, 70 patients who underwent myelomeningocele repair between 19 and 27 weeks of gestation; and a control group (65). We compared the rate of hydrocephalus treatment, the clivus-supraocciput angle (CSA), and the Welcher angle. RESULTS: The mean CSA in the fetal group was 87.6°, and the postnatal group was significantly different at 78.3° (p < 0.0001). The control group (89.1°) was significantly different from the postnatal group but not from the fetal group. The mean Welcher angle was not significantly different between the groups. There was an 8.5% rate of surgical treatment for hydrocephalus in the fetal group, compared with 73.6% in the postnatal group. CONCLUSIONS: The CSA in the fetal group was larger than that in the postnatal group, which may explain the decrease in the prevalence of hydrocephalus in the fetal group.
Entities:
Keywords:
Fetal surgery; Hydrocephalus; Myelomeningocele; Skull base
Authors: Abigail Wilpers; Anna Y Lynn; Barbara Eichhorn; Amy B Powne; Megan Lagueux; Janene Batten; Mert Ozan Bahtiyar; Cary P Gross Journal: Fetal Diagn Ther Date: 2022-03-10 Impact factor: 2.208