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Alterations in skull base anatomy in intrauterine and postnatal repaired myelomeningoceles

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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.

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

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Authors and Affiliations

  1. Department of Neurosurgery, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil

    Marcos Devanir Silva da Costa, Jardel Mendonça Nicacio, Patricia Alessandra Dastoli, Italo Capraro Suriano & Sergio Cavalheiro

  2. Department of Fetal Neurosurgery, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil

    Marcos Devanir Silva da Costa, Jardel Mendonça Nicacio, Patricia Alessandra Dastoli, Italo Capraro Suriano & Sergio Cavalheiro

  3. Department of Obstetrics, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil

    Stéphanno Gomes Pereira Sarmento, Mauricio Mendes Barbosa & Antonio Fernandes Moron

  4. Department of Fetal Medicine, Hospital e Maternidade Santa Joana, São Paulo, SP, Brazil

    Stéphanno Gomes Pereira Sarmento, Mauricio Mendes Barbosa & Antonio Fernandes Moron

Authors
  1. Marcos Devanir Silva da Costa
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  2. Jardel Mendonça Nicacio
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  3. Patricia Alessandra Dastoli
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  4. Italo Capraro Suriano
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  5. Stéphanno Gomes Pereira Sarmento
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  6. Mauricio Mendes Barbosa
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  7. Antonio Fernandes Moron
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  8. Sergio Cavalheiro
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Corresponding author

Correspondence to Marcos Devanir Silva da Costa.

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Statement of ethics

The study was approved by the Research Ethics Committee of the Universidade Federal de São Paulo, São Paulo, Brazil, under opinion number 2,461,706 (CAAE 79580517.6.0000.5505) on January 08, 2018. Informed consent was waived due to the retrospective nature of the study.

Conflict of interest

The authors declare that they have no conflicts of interest.

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da Costa, M.D.S., Nicacio, J.M., Dastoli, P.A. et al. Alterations in skull base anatomy in intrauterine and postnatal repaired myelomeningoceles. Childs Nerv Syst 36, 2757–2763 (2020). https://doi.org/10.1007/s00381-020-04587-6

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  • DOI: https://doi.org/10.1007/s00381-020-04587-6

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