Surgical Techniques for Craniosynostosis

Craniosynostosis is a condition in which the skull has an abnormal shape. It develops when there is a failure in the growth of two or more than two bones out of the seven main bones of the cranium after the cranial sutures fuse prematurely. As a result, the normal development of the skull and the brain is affected. There are many reliable and experienced plastic surgeons that can help in correcting this congenital deformity. Craniosynostosis surgery is usually recommended. The type of surgery is determined by various factors such as the preference of the caretaker, the age of the child as well as other medical conditions, if present.

Corrects Deformities of the Skull Bone and Face
Craniosynostosis may be attributed to isolated or inherited genes. Sometimes, there is no specific cause for this condition. In majority of the cases it is the shape of the skull that is mostly affected. However, this deformity is not restricted to the skull alone; sometimes facial features are also affected. In many cases, surgical treatment is recommended and is performed for infants who are below three months of age. It can be performed later as well, when they are nine to twelve months of age.

Types of Craniosynostosis

• Metopic Synostosis
In this, the forehead has a triangular shape. There is a wide variation in the deformity. This may be mild and no operative intervention is required. However, some cases may require surgery.
• Saggital Synostosis
Treatment for this condition is best performed when the infant is below three months of age. A minimally invasive procedure is used for providing a more natural shape for the head.
• Unilateral Coronal Synostosis
This would include the deformities of the forehead, nose and the eye. Reconstructive surgery would be performed when the infant is nine to twelve months of age. The surgeon would reshape the bone that creates the brow. Remodeling of the forehead is done for giving more naturalness and symmetry to the face.
• Multiple suture Synostosis
This is a serious condition in which multiple sutures of the cranium prematurely fuse. There is a possibility of brain abnormalities too. Various surgeries would be required for correcting this type of synostosis.

Surgical Options for Craniosynostosis A plastic surgeon would adopt one of the two common procedures for craniosynostosis:

• Traditional surgery or calvarial vault remodeling
• Endoscopic surgery that is minimally invasive

In the traditional surgery, the surgeon makes an incision in the child’s scalp. The area that is abnormally fused is moved to correct the shape of the head. Then the skull is reshaped to look more natural. This is provided when the baby is more than 6 months of age. The surgery may require up to eight hours. The baby will be monitored in the ICU for one night and after that will have to spend 3 to 5 days in the hospital.

The endoscopic method is minimally invasive and is provided when the baby is less than 3 months old. It utilizes an endoscope, which is a small tube through which the surgeon can view the inside and outside portions of the skull. Very small incisions are made on the scalp for this procedure. The prematurely fused suture is opened up so that the baby’s brain can grow normally. This surgery lasts up to one hour; blood loss is less compared to the traditional surgery. The baby will have to spend one night in the hospital, but can go home the next day.