Endoscopic-assisted repair for sagittal synostosis

Area of Science:

• Craniofacial Surgery
• Pediatric Neurosurgery
• Minimally Invasive Surgery

Background:

• Craniosynostosis is a condition where skull sutures fuse prematurely.
• Single-suture synostosis affects infants and requires surgical intervention for proper skull development.
• Endoscopic techniques offer less invasive surgical options.

Purpose of the Study:

• To describe the technique and outcomes of endoscopy-assisted synostosis surgery.
• To evaluate the suitability of this method for infants under 6 months with single-suture synostosis.
• To highlight the benefits of minimally invasive approaches in pediatric craniofacial surgery.

Main Methods:

• Endoscopy-assisted synostosis surgery performed since 2006 at St. Louis Children's Hospital.
• Patient selection criteria: infants < 6 months with single-suture synostosis.
• Surgical technique involves the sphinx position, two incisions, epidural dissection, and bone edge cauterization via endoscope.

Main Results:

• Rarely requires blood products for single suturectomies.
• Patients managed on the floor post-surgery.
• Discharged home on postoperative day 1.
• Helmet therapy initiated immediately post-surgery and continued until ~12 months of age.

Conclusions:

• Endoscopy-assisted synostosis surgery is a safe and effective procedure for eligible infants.
• Minimally invasive approach leads to shorter hospital stays and quick recovery.
• Early intervention with helmet therapy supports optimal skull remodeling.