Late-Presenting Sagittal Craniosynostosis: An Update to a Standardized Treatment Protocol

Area of Science:

• Craniofacial surgery
• Pediatric neurosurgery
• Neurosurgery

Background:

• Sagittal craniosynostosis is a condition where the sagittal suture fuses prematurely.
• Late-presenting cases (after age 1 year) were previously addressed with a specific protocol.
• This study provides a follow-up and outcome evaluation of that cohort.

Purpose of the Study:

• To evaluate the outcomes of a previously published treatment protocol for late-presenting sagittal craniosynostosis.
• To assess the need for surgical intervention in patients presenting after one year of age.

Main Methods:

• A cohort of 108 patients with isolated sagittal craniosynostosis presenting after age 1 year was analyzed.
• Patients were treated between July 2013 and April 2021.
• Follow-up data was collected to evaluate outcomes of surgical and conservative management.

Main Results:

• 108 patients were included, with an average age of 5.2 years at presentation.
• 11.1% of patients required surgery initially for reasons including papilledema and elevated intracranial pressure.
• Only 4.2% of patients managed conservatively ultimately required surgery for various indications.

Conclusions:

• Late-presenting sagittal craniosynostosis often requires less surgical intervention compared to younger patients.
• Conservative management appears effective for a significant majority of these patients.
• The milder phenotype in older patients may explain the lower surgical rates.