Craniosynostosis: Experience From a Single Tertiary Center in India

Introduction Premature fusion of one or more cranial sutures results in a diverse set of conditions collectively known as craniosynostosis. It is primarily responsible for cosmetic issues and occasionally associated with complications like brain growth restriction, raised intracranial pressure (ICP), and blindness. Management ranges from conservative surgical procedures such as suturectomies to more extensive procedures, including frontal bone remodeling with fronto-orbital advancement (FBR with FOA) and total calvarial reconstructions (TCVR). Currently, there is no consensus on an ideal procedure for a particular type of surgery for this condition. Methods A retrospective review of 26 consecutive patients treated at a single tertiary center in India was performed. Sloan's surgical outcome class and parent satisfaction score to compare different forms of intervention. Transfusion requirements, length of hospital, and increase in head circumference post-operation were also used. Results The mean age in our cohort was 10.9 months, with a ratio of 9:4 male-to-female. The overall assessment of pre- vs. post-operative head circumference revealed a strong significant mean improvement from 42.85 cm to 44.73 cm (p<0.001). A comparison of measured variables for all 26 patients revealed a significant difference in Sloan's surgical outcomes class (5.4 vs 1.2, p<0.001), Parent satisfaction score (5.1 vs 9.1, p<0.001) and increase in head circumference (cm) post-operation (0.74 vs 2.39, p<0.001) when comparing suturectomies vs extensive procedure like FBR with FOA and TCVR.  Conclusion Our results favored FBR with FOA and TCVR over simple suturectomies for more satisfactory and long-lasting results with acceptable mortality and morbidity.