Craniosynostosis: Experience From a Single Tertiary Center in India

Area of Science:

• Pediatric Surgery
• Neurosurgery
• Craniofacial Surgery

Background:

• Craniosynostosis involves premature fusion of cranial sutures, causing cosmetic issues and potential complications like increased intracranial pressure (ICP).
• Current management strategies for craniosynostosis vary, with no established consensus on the optimal surgical approach for specific presentations.

Purpose of the Study:

• To compare the efficacy and outcomes of different surgical interventions for craniosynostosis.
• To evaluate whether extensive procedures offer superior results compared to conservative methods.

Main Methods:

• A retrospective review of 26 consecutive craniosynostosis patients treated at a single tertiary center.
• Surgical outcomes were assessed using Sloan's surgical outcome class and parent satisfaction scores.
• Additional metrics included transfusion requirements, length of hospital stay, and postoperative head circumference increase.

Main Results:

• Extensive procedures (FBR with FOA, TCVR) showed significantly better Sloan's outcome scores (1.2 vs 5.4) and parent satisfaction (9.1 vs 5.1) compared to simple suturectomies.
• A significant mean increase in head circumference was observed post-operation (2.39 cm vs 0.74 cm) favoring extensive procedures.
• The mean age of patients was 10.9 months, with a male-to-female ratio of 9:4.

Conclusions:

• Frontal bone remodeling with fronto-orbital advancement (FBR with FOA) and total calvarial reconstructions (TCVR) are favored over simple suturectomies for craniosynostosis.
• These extensive procedures provide more satisfactory and durable results with acceptable safety profiles.
• The study highlights the benefits of advanced surgical techniques in managing craniosynostosis.