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The Outcomes of Endoscopic Suturectomy in Syndromic Craniosynostosis
Youngbo Shim1,2, Seung-Ki Kim1,3, Jung Min Ko4
1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine.
Insights
Endoscopic suturectomy shows promising results for infants with syndromic craniosynostosis, offering a safe and effective treatment option. This procedure can serve as a crucial preliminary step before more extensive surgeries if needed.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Craniosynostosis, premature fusion of skull sutures, affects infants.
- Endoscopic suturectomy is a common treatment for nonsyndromic craniosynostosis.
- Efficacy and safety in syndromic craniosynostosis remain less understood.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscopic suturectomy in syndromic craniosynostosis patients.
- To compare outcomes between syndromic and nonsyndromic patients with bilateral coronal synostosis.
Main Methods:
- Retrospective analysis of 242 patients undergoing endoscopic suturectomy (2013-2020).
- Focused on 26 syndromic patients with >1 year follow-up.
- Compared outcomes in syndromic (N=12) vs. nonsyndromic (N=11) bilateral coronal synostosis cases with >1 year follow-up.
Main Results:
- 88% of syndromic patients had favorable outcomes without major complications.
- 92% of syndromic bilateral coronal synostosis patients had favorable outcomes.
- No significant differences in anthropometric indices or surgical outcomes between syndromic and nonsyndromic groups.
Conclusions:
- Endoscopic suturectomy is a viable surgical option for syndromic craniosynostosis.
- It can act as a beneficial bridge therapy for infants awaiting further surgical intervention.
Objective:
Endoscopic suturectomy is a widely practiced surgical option for infants with craniosynostosis. But the efficacy and safety of the procedure remain unclear in syndromic patients. This study aims to evaluate the efficacy and safety of endoscopic suturectomy for patients with syndromic craniosynostosis.
Methods:
From January 2013 to December 2020, 242 patients underwent endoscopic suturectomy at our institution. The surgical outcome was determined to be favorable or unfavorable based upon the necessity of an additional cranial surgery upon the last follow-up. First, we analyzed the outcomes of 26 syndromic craniosynostosis patients who have followed up for over a year. Second, we compared the outcomes between the syndromic (N=12) and nonsyndromic (N=11) patients with bilateral coronal synostosis who have followed up for over a year.
Results:
Twenty-three out of 26 syndromic craniosynostosis patients (88%) showed favorable outcomes without significant complications. In the analysis for bilateral coronal synostosis patients, 11 of 12 syndromic patients (92%) presented favorable outcomes, and all nonsyndromic patients showed favorable outcomes. No significant differences were observed in various anthropometric indices (cranial index, intracranial volume, anterior cranial height, anterior cranial base length, and cranial height-length index) and surgical outcomes between syndromic and nonsyndromic groups.
Conclusions:
Endoscopic suturectomy has the potential to be a surgical option for syndromic craniosynostosis. Even for patients with unfavorable outcomes, endoscopic suturectomy could serve as a bridge treatment for infants to counter cranial deformation before additional extensive surgery.
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