Endoscopy-Assisted Craniosynostosis Surgery without Postoperative Helmet Molding Therapy.

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Surgical Outcomes Research

Background:

• Endoscopy-assisted craniosynostosis surgery (EACS) offers benefits like reduced blood loss and shorter hospital stays.
• Postoperative helmet therapy (PHT) is standard for head shape correction but involves high costs and potential complications.
• There is a need to evaluate EACS outcomes without PHT, especially considering healthcare access limitations.

Purpose of the Study:

• To analyze the anthropometric outcomes of the first series of EACS performed without PHT.
• To assess the efficacy of EACS in correcting head shape for nonsyndromic isolated sagittal synostosis without subsequent helmet use.

Main Methods:

• Retrospective analysis of 90 consecutive EACS patients (2012-2022), with 33 meeting criteria for isolated sagittal synostosis.
• Craniometric measurements (cephalic index) were taken preoperatively, at 1 year postoperatively, and at latest follow-up (>3 years).
• Statistical analysis of cephalic index changes and classification of results (excellent, good, poor) based on defined thresholds.

Main Results:

• The mean preoperative cephalic index (CI) of 68 improved to 76 at 1 year postoperatively (mean increase of +8, P=0.0001).
• 71% of patients achieved excellent results (CI >75), 23% good (CI 70-75), and 6% poor (CI <70).
• No reinterventions were necessary, indicating successful head shape correction.

Conclusions:

• EACS without PHT yields favorable anthropometric results for nonsyndromic isolated sagittal synostosis.
• This approach simplifies postoperative management and reduces overall treatment costs.
• EACS without PHT is a viable and effective alternative to traditional methods.