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Outcomes following Craniosynostosis Surgery at a Tertiary Care Center in the Middle East
Omar Najjar1, Naji AbouChebel2, Carine Zeeni3
1The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Insights
Open craniosynostosis surgery in infants is safe and effective, yielding good cosmetic results with low complication rates. This study highlights surgical outcomes in Lebanon, emphasizing the need for more Middle Eastern data.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Craniofacial Surgery
Background:
- Open surgical approaches are vital for complex craniosynostosis in infants over 6 months.
- Craniosynostosis clinical features are understudied in the Middle East.
- This study evaluates craniosynostosis surgery in a Lebanese tertiary center.
Purpose of the Study:
- To assess clinical features of craniosynostosis in infants.
- To evaluate surgical outcomes and complications.
- To characterize craniosynostosis patterns in the Middle East.
Main Methods:
- Retrospective review of 35 infants undergoing craniosynostosis surgery (2006-2018).
- Analysis of clinicodemographic data, complications, and recurrence.
- Descriptive statistics were used for evaluation.
Main Results:
- Metopic synostosis was most common (28.6%), followed by unilateral coronal (25.7%) and sagittal (20.0%).
- Five patients (14.3%) had syndromic craniosynostosis.
- Low complication rates (5.7%) and reoperation rates (8.6%) were observed, with high caregiver satisfaction.
Conclusions:
- Open craniosynostosis surgery offers minimal complications and good cosmetic outcomes with proper care.
- Further population-level data are essential for understanding Middle Eastern craniosynostosis patterns.
- This study provides valuable insights into craniosynostosis management in the region.
Background:
Despite advancements in craniosynostosis surgery, open surgical approaches remain crucial for the management of infants >6 months of age and in those with complex synostosis. The clinical features of craniosynostosis remain poorly characterized in the Middle East. This study sought to assess the clinical features and outcomes of infants undergoing craniosynostosis surgery at a tertiary care center in Lebanon.
Methods:
A retrospective review was performed of all patients who underwent craniosynostosis surgery from December 2006 to December 2018 at the American University of Beirut Medical Center, Lebanon. Clinicodemographic characteristics, complications, and recurrence outcomes were recorded and evaluated using descriptive statistics.
Results:
Thirty-five infants met the inclusion criteria, with a mean age of 9.0 ± 4.0 months. The most common site of suture involvement was metopic (28.6%), followed by unilateral coronal (25.7%), sagittal (20.0%), bicoronal (8.6%), and multiple sites (17.1%). Five patients (14.3%) had syndromic synostosis. Median estimated blood loss was 200 mL, and median volume of transfused packed red blood cells was 180 mL. Two patients (5.7%) experienced postoperative complications, including postoperative blood transfusion (n = 1)and wire protrusion requiring removal (n = 1). Three patients (8.6%) required reoperation: 2 (5.7%) for resynostosis and 1 for traumatic fracture repair. Caregivers of all patients reported high satisfaction with cosmetic outcomes 4 weeks postoperatively.
Conclusions:
With appropriate perioperative precautions, open craniosynostosis surgery can be performed with minimal complications, low recurrence rates, and satisfactory cosmetic outcomes. Additional population-level data are needed to better characterize craniosynostosis patterns and outcomes in the Middle East.
