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Endoscope-assisted strip craniectomy and postoperative helmet therapy for treatment of craniosynostosis
John Berry-Candelario1, Emily B Ridgway, Ronald T Grondin
1Departments of Neurological Surgery, Children’s Hospital Boston, Harvard Medical School, Massachusetts, USA.
Insights
Endoscope-assisted strip craniectomy and postoperative helmet therapy (EASC + PHT) offers a safe and effective treatment for craniosynostosis in infants. This minimally invasive approach reduces operative time, hospital stays, and the need for blood transfusions.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Minimally Invasive Surgery
Background:
- Craniosynostosis requires timely intervention for proper brain growth and deformity correction.
- Endoscopic techniques offer potential advantages in treating complex pediatric conditions.
Purpose of the Study:
- To evaluate the safety and efficacy of endoscope-assisted strip craniectomy and postoperative helmet therapy (EASC + PHT) for craniosynostosis.
- To provide evidence supporting EASC + PHT for various forms of craniosynostosis.
Main Methods:
- Retrospective review of 173 patients treated with EASC + PHT at Children's Hospital Boston.
- Data collected included deformity type, age, transfusions, operative time, hospital stay, and anthropometrics.
Main Results:
- Mean operative time was 46.3 minutes; only 4.6% required transfusions.
- Average hospital stay was 1.35 days, with most discharged the day after surgery.
- Complications and need for further reconstruction were analyzed.
Conclusions:
- EASC + PHT is a safe and effective early treatment for craniosynostosis.
- Demonstrable benefits include reduced hospital stay and fewer blood transfusions, indicating cost-effectiveness.
Abstract:
OBJECT The primary goals of treatment in the infant with craniosynostosis are to correct the deformity and allow for adequate brain growth in as safe and effective a manner as possible. Herein, the authors present the results of treating craniosynostosis using an endoscope-assisted strip craniectomy and postoperative helmet therapy (EASC + PHT) in the hopes of providing further evidence of its role in the treatment of multiple different forms of craniosynostosis. This is a retrospective review of the patients treated with this technique at Children's Hospital Boston. METHODS The electronic medical records of all children with craniosynostosis treated using this technique were reviewed retrospectively. A priori, data were collected for deformity type, patient age at surgery, number of transfusions, operative time, length of hospital stay, and anthropometric measurements. RESULTS One hundred seventy-three patients (61 females and 112 males) were treated at our institution between July 2004 and March 2011 with EASC + PHT. The mean operative time was 46.30 minutes. Eight (4.6%) of the 173 patients received blood transfusions. The average length of hospital stay was 1.35 days, with the majority of patients being discharged the day after surgery. All complications and any patient who required additional craniofacial reconstructions are discussed. In addition, a subgroup analysis was done for patients who had undergone surgery and had longer than 1 year of follow-up. CONCLUSIONS The authors' growing database of patients supports the experiences described by others that early treatment of craniosynostosis with an EASC + PHT is a safe and efficacious technique. In addition, cost reduction due to decreased hospital stay and limitation of blood transfusions are demonstrable benefits associated with the use of this technique.
