Endoscopic Versus Open Repair for Craniosynostosis in Infants Using Propensity Score Matching to Compare Outcomes: A...

Area of Science:

• Pediatric Surgery
• Craniofacial Surgery
• Medical Device Technology

Background:

• The Pediatric Craniofacial Surgery Perioperative Registry was established to evaluate craniosynostosis repair outcomes.
• A multicenter study aimed to compare endoscopic-assisted craniectomy (ESC) with open repair in infants.
• The study hypothesized ESC advantages observed in single-center studies would be confirmed by registry data.

Purpose of the Study:

• To assess differences in blood utilization, ICU stays, hospitalization duration, and complications between ESC and open craniosynostosis repair.
• To validate the benefits of ESC in a large, multicenter dataset.
• To compare perioperative outcomes in infants undergoing craniosynostosis repair.

Main Methods:

• Data from 1382 infants (<12 months) were analyzed from 31 institutions (June 2012-September 2015).
• Infants underwent either open repair or endoscopic craniectomy (ESC).
• Propensity score matching and conditional logistic regression were used for comparative analysis.

Main Results:

• ESC group showed significantly reduced blood product use (26% vs 81%), shorter anesthesia (168 vs 248 min) and surgical times (70 vs 130 min), and fewer ICU days (0 vs 2).
• Hospital length of stay was significantly lower for ESC (2 vs 4 days).
• Complication rates were similar, but postoperative intubation was higher in the open repair group (10% vs 2%).

Conclusions:

• Endoscopic-assisted craniectomy (ESC) offers significant advantages over open repair for infants with craniosynostosis.
• ESC is associated with reduced resource utilization and potentially improved clinical outcomes and safety.
• This large multicenter study supports the widespread adoption of ESC for infant craniosynostosis repair.