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Craniosynostosis: surgical treatment during the first year of life
C di Rocco1, E Marchese, F Velardi
1Institute of Neurosurgery, Catholic University, Rome, Italy.
Insights
Early surgical intervention for craniosynostosis in infants under one year old yields excellent cosmetic outcomes and promotes physiological craniofacial growth. This study highlights the safety and benefits of timely treatment for this condition.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Neurosurgery
Background:
- Craniosynostosis, the premature fusion of cranial sutures, affects approximately 1 in 2,500 live births.
- Early diagnosis and surgical intervention are crucial for preventing increased intracranial pressure and ensuring proper brain development.
- The timing and surgical approach for craniosynostosis repair are critical for optimal outcomes.
Purpose of the Study:
- To evaluate the outcomes of early surgical correction of craniosynostosis in infants.
- To compare surgical techniques based on the specific sutures involved.
- To assess the safety, efficacy, and long-term benefits of treating craniosynostosis in infants under one year of age.
Main Methods:
- A retrospective review of 276 children with craniosynostosis operated on over a 9-year period.
- Classification of patients into two groups based on the affected sutures: sagittal suture (Group I) and anterior/posterior sutural complex (Group II).
- Application of distinct surgical techniques tailored to each group: linear craniectomies for Group I and more complex reconstructive procedures for Group II.
Main Results:
- A total of 231 infants were operated on before one year of age.
- Low rates of morbidity, mortality, and recurrence were observed across both surgical groups.
- Infants tolerated the surgical procedures well, comparable to older children.
Conclusions:
- Early surgical intervention for craniosynostosis in infants is safe and effective.
- Tailored surgical approaches based on suture involvement lead to favorable outcomes.
- Infants benefit from early treatment with improved cosmetic results and more physiological craniofacial growth.
Abstract:
Out of 276 children with craniosynostosis operated on in a 9 year period, 231 were operated on under 1 year of age. According to the sutures involved in the process of early fusion, two groups of infants were individuated. Patients belonging to the first group were characterized by the involvement of the sagittal suture, while infants of group II presented with a synostosis of the anterior or posterior sutural complex. Two different techniques were required for the 2 groups of subjects, the first of them being mainly based on linear craniectomies, the second requiring more complex reconstructive surgical procedures. The morbidity, mortality and recurrence rates of the series were low, demonstrating that infants can tolerate the procedure as well as older children. The advantage of the early treatment consists of a better cosmetic result with a more physiological growth of faciocranial skeleton.