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Endoscopic surgery for craniosynostosis: A systematic review and single-arm meta analysis
Silvio Porto Junior1, Davi Amorim Meira1, Beatriz Lopes Bernardo da Cunha2
1Bahiana School of Medicine and Public Health, Dom João VI Avenue, 275, Brotas, Salvador, Bahia, Brazil.
Clinical Neurology and Neurosurgery
|May 15, 2024
Summary
Endoscopic surgery for craniosynostosis is safe and effective, with low complication rates. Further research is needed to confirm long-term outcomes of this minimally invasive approach for skull development.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Developmental Biology
Background:
- Craniosynostosis is a birth defect causing abnormal skull shape and potential brain development issues due to premature suture fusion.
- Surgical treatments have advanced from open procedures to minimally invasive endoscopic techniques.
- Evaluating the safety and effectiveness of endoscopic craniosynostosis repair is crucial.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness and safety of endoscopic techniques for craniosynostosis correction.
- To assess clinical and surgical outcomes, including operative time, hospital stay, blood loss, and complications.
- To identify variations in surgical approaches and areas needing further research.
Main Methods:
- Systematic review and meta-analysis adhering to Cochrane standards and PRISMA guidelines.
- Searched PubMed, Embase, and Web of Science for studies up to December 2023.
- Included 30 studies (2561 patients) with at least five patients per study; assessed bias using ROBINS-I.
Main Results:
- Endoscopic repair showed a mean operative time of 68.06 minutes and a median hospital stay of 1.28 days.
- Low complication rates (1.86%) and reoperation rates (3.07%) were observed, with no procedure-related mortality.
- Helmet therapy was common post-operation (median 9 months), but significant variations in surgical approach and timing exist.
Conclusions:
- Endoscopic craniosynostosis repair is a safe and effective treatment option.
- Favorable surgical outcomes and low complication risks are associated with the endoscopic approach.
- Further high-quality, controlled trials are necessary to validate findings and understand long-term results due to study limitations.
