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Netherton J, Horton J, Stock NM, Shaw R, Noons P, Evans MJ. Psychological Adjustment in Apert Syndrome: Parent and Young Person Perspectives. Cleft Palate Craniofac J 2023; 60:461-473. [PMID: 34967688 DOI: 10.1177/10556656211069817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To date, limited research has been carried out into the psychological impact of having a diagnosis of Apert syndrome (AS) and the life experiences of families living with this condition. The aim of the current study was to explore psychological adjustment to AS from the perspectives of young people, and their parents, with the broader goal of informing care, and support for this population. Four young people (2 male) aged 11 to 15 years and their mothers were interviewed in their homes using a semistructured interview guide and photo-elicitation methods. Transcripts were analyzed using Interpretive Phenomenological Analysis. Three superordinate themes were identified from the data: (1) Acceptance and Adjustment: A Cyclical Journey; (2) A Barrier to Adjustment: Navigating Treatment; and (3) Facilitating Adjustment: Social Support. Families described adjustment as a cyclical process, which was sensitive to change, particularly in the context of ongoing medical treatment. Families also utilized many resources, particularly in the form of social support, to adjust to the challenges of AS and build resilience. The findings of this study have important implications for the implementation of patient-centered care within designated craniofacial treatment centers, which should at a minimum include the provision of reliable information throughout the treatment pathway, additional support from health professionals at key times of transition, and the coordination of support across medical teams, and other key organizations in the child's life.
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Affiliation(s)
- Jennifer Netherton
- Health in Mind Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
| | - Jo Horton
- Health in Mind Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
| | - Nicola M Stock
- Centre for Appearance Research, University of the West of England UK, Bristol, United Kingdom
| | - Rachel Shaw
- School of Psychology, 14288Aston University UK, Birmingham, United Kingdom
| | - Peter Noons
- Craniofacial Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
| | - Martin J Evans
- Craniofacial Team, 1729Birmingham Women's and Children's Hospital UK, Birmingham, United Kingdom
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Junaid M, Slack-Smith L, Wong K, Baynam G, Calache H, Hewitt T, Leonard H. Epidemiology of Hospital Admissions for Craniosynostosis in Australia: A Population-Based Study. Cleft Palate Craniofac J 2022; 60:569-576. [PMID: 35130078 DOI: 10.1177/10556656221074215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
To describe trends, age, and sex-specific patterns of population hospital admissions with a diagnosis of craniosynostosis (CS) in Australia. Population data for hospital separations (in-patient) from public and private hospitals (July 1996-June 2018) were obtained from the publicly available Australian Institute of Health and Welfare (AIHW) National Hospital Morbidity Database. The outcome variables were hospital separation rates (HSR) (number of hospital separations divided by the estimated resident population [ERP] per year) and average length of stay (aLOS) (patient days divided by the number of hospital separations) with a diagnosis of CS. Trends in HSR and aLOS adjusted for age, sex, and type of CS were investigated by negative binomial regression presented as annual percent change (APC). In 8057 admissions identified, we observed no significant change in the annual trend for HSR for the 22-year period. However, a marginal annual decrease of 1.6% (95% CI: -0.7, -2.4) in the aLOS was identified for the same time period. HSR were higher for males, infants, and single suture synostosis. aLOS was 3.8 days (95% CI: 3.8, 3.9) per visit, longer for syndromic conditions. There was a minor reduction in the average length of hospital stay for CS over the 22-year period potentially indicative of improved care. Population-level information on hospitalisations for rare craniofacial conditions can inform research, clinical, and surgical practice.
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Affiliation(s)
- Mohammed Junaid
- School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia.,117610Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Nedlands, Western Australia, Australia.,117610Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Kingsley Wong
- 117610Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Gareth Baynam
- 117610Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia.,Department of Health, 569007Genetic Services of Western Australia, Perth, Western Australia, Australia
| | - Hanny Calache
- School of Health and Social Development, Faculty of Health, Deakin Health Economics, Institute of Health Transformation, 91844Deakin University, Geelong, Victoria, Australia.,Department of Dentistry and Oral Health, 56371La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Timothy Hewitt
- Department of Plastic Surgery, 60081Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Helen Leonard
- 117610Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia.,Faculty of Health and Medical Sciences, Centre of Child Health Research, University of Western Australia, Nedlands, Western Australia, Australia
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Munarriz PM, Pascual B, Castaño-Leon AM, García-Recuero I, Redondo M, de Aragón AM, Romance A. Apert syndrome: Cranial procedures and brain malformations in a series of patients. Surg Neurol Int 2020; 11:361. [PMID: 33194294 PMCID: PMC7655990 DOI: 10.25259/sni_413_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/28/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Apert syndrome is one of the most severe craniofacial disorders. This study aims to describe the craniofacial surgeries and central nervous system malformations of a cohort of children with Apert syndrome treated in the past 20 years and to compare these data with previously published data. Methods: Retrospective analysis of a series of patients with Apert syndrome treated between 1999 and 2019 in our hospital. Information was analyzed regarding craniofacial procedures, hydrocephalus and presence of shunts, Chiari malformation Type 1, and other brain malformations such as corpus callosum and septum pellucidum anomalies. Results: Thirty-seven patients were studied. Ventriculoperitoneal shunt prevalence was 24.3%, and 8.1% of patients required decompressive surgery for Chiari malformation. All of them needed at least one cranial vault remodeling procedure. The median age for this procedure was 8 months. In 69.7% of patients, the first cranial vault intervention was performed in the fronto-orbital region. In 36.4% of patients, a midface advancement had been performed at the time of this review, although this proportion was very dependent on the follow-up period and the age of the patients. The median age for the midface advancement procedure was 5.25 years. Anomalies of the corpus callosum and the septum pellucidum were reported in 43.2% and 59.5% of patients, respectively. Conclusion: Apert syndrome is a type of syndromic craniosynostosis, and patients usually require one or more cranial and facial surgeries. In comparison with other syndromic craniosynostosis types, Apert syndrome less frequently requires a VP shunt or treatment for a Chiari malformation.
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Affiliation(s)
- Pablo M Munarriz
- Department of Neurosurgery, Hospital 12 de Octubre, Madrid, Spain.,Department of Craniofacial Unit (ERN CRANIO), Hospital 12 de Octubre, Madrid, Spain
| | - Beatriz Pascual
- Department of Neurosurgery, Hospital 12 de Octubre, Madrid, Spain.,Department of Craniofacial Unit (ERN CRANIO), Hospital 12 de Octubre, Madrid, Spain
| | - Ana M Castaño-Leon
- Department of Neurosurgery, Hospital 12 de Octubre, Madrid, Spain.,Department of Craniofacial Unit (ERN CRANIO), Hospital 12 de Octubre, Madrid, Spain
| | - Ignacio García-Recuero
- Department of Oral and Maxillofacial Surgery Hospital 12 de Octubre, Madrid, Spain.,Department of Craniofacial Unit (ERN CRANIO), Hospital 12 de Octubre, Madrid, Spain
| | - Marta Redondo
- Department of Oral and Maxillofacial Surgery Hospital 12 de Octubre, Madrid, Spain.,Department of Craniofacial Unit (ERN CRANIO), Hospital 12 de Octubre, Madrid, Spain
| | - Ana Martínez de Aragón
- Department of Radiology, Hospital 12 de Octubre, Madrid, Spain.,Department of Craniofacial Unit (ERN CRANIO), Hospital 12 de Octubre, Madrid, Spain
| | - Ana Romance
- Department of Oral and Maxillofacial Surgery Hospital 12 de Octubre, Madrid, Spain.,Department of Craniofacial Unit (ERN CRANIO), Hospital 12 de Octubre, Madrid, Spain
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Long-Term Functional Upper-Extremity Outcomes in Adults with Apert Syndrome. Plast Reconstr Surg 2019; 143:1136-1145. [DOI: 10.1097/prs.0000000000005479] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Driessen C, van Veelen MLC, Joosten KFM, Versnel SL, van Nieuwenhoven CA, Wolvius EB, Bredero-Boelhouwer HH, Arnaud E, Mathijssen IMJ. Apert syndrome: the Paris and Rotterdam philosophy. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1335195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- C. Driessen
- Department of Plastic and Reconstructive Surgery, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
| | - M. L. C. van Veelen
- Department of Neurosurgery, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
| | - K. F. M. Joosten
- Department of Paediatric Intensive Care Medicine, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
| | - S. L. Versnel
- Department of Plastic and Reconstructive Surgery, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
| | - C. A. van Nieuwenhoven
- Department of Plastic and Reconstructive Surgery, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
| | - E. B. Wolvius
- Department of Maxillofacial surgery, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
| | - H. H. Bredero-Boelhouwer
- Department of Plastic and Reconstructive Surgery, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
| | - E. Arnaud
- Department of Plastic and Reconstructive Surgery, Pediatric Craniofacial Unit Hospital Necker, Paris, France
| | - I. M. J. Mathijssen
- Department of Plastic and Reconstructive Surgery, Dutch Craniofacial Center, Sophia children’s hospital, Rotterdam, The Netherlands
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