Head Shape After Sagittal Craniosynostosis Surgery: Open Versus Endoscopic Strip Craniectomy

Area of Science:

• Neurosurgery
• Pediatric Surgery
• Craniofacial Surgery

Background:

• Nonsyndromic sagittal craniosynostosis requires surgical intervention to correct skull deformities and prevent increased intracranial pressure.
• Current surgical options include open strip craniectomy and endoscopic strip craniectomy.

Purpose of the Study:

• To compare the effectiveness and outcomes of open versus endoscopic strip craniectomy for treating nonsyndromic sagittal craniosynostosis.
• To evaluate changes in cephalic index (CI), operative details, and complications between the two surgical techniques.

Main Methods:

• Retrospective chart review of 51 patients with nonsyndromic sagittal craniosynostosis treated between 2011 and 2016.
• Patients were categorized into open surgery (13) or endoscopic strip craniectomy (38) groups.
• Head shape assessed via pre- and postoperative cephalic index (CI); complications and operative data were compared.

Main Results:

• Both endoscopic and open techniques significantly improved postoperative CI, with no significant difference in initial improvement.
• Endoscopic surgery resulted in significantly less intraoperative blood loss and shorter hospital stays.
• Long-term follow-up showed no significant CI regression in the endoscopic group, versus a small regression in the open group.

Conclusions:

• Both endoscopic and open strip craniectomy are effective for nonsyndromic sagittal synostosis, yielding similar initial head shape correction.
• Endoscopic strip craniectomy is associated with reduced intraoperative morbidity, including less blood loss and shorter hospitalizations.
• The findings support the use of either surgical technique, aligning with existing literature.