Long-Term Intracranial and Ophthalmologic Outcomes in Single Suture Craniosynostosis

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Population Health

Background:

• Long-term intracranial and ophthalmologic sequelae of single suture craniosynostosis are not well-defined at a population level.
• Previous studies have limitations due to small sample sizes and short follow-up periods.

Purpose of the Study:

• To characterize the prevalence of long-term intracranial and ophthalmologic morbidity in single suture craniosynostosis.
• To investigate the association between surgical timing and postoperative outcomes.

Main Methods:

• Retrospective cohort study using the Pediatric Health Information System (2015-2024).
• Included children with single-suture craniosynostosis undergoing surgical correction, excluding syndromic/genetic comorbidities.
• Compared intracranial diagnosis prevalence by suture type and used logistic regression to assess surgical timing's impact on outcomes.

Main Results:

• 1602 children included with a mean follow-up of 5.3 years.
• Sagittal synostosis linked to elevated intracranial pressure (ICP); unicoronal to ophthalmologic complications; lambdoid to Chiari I malformation.
• Surgery after 6 months, particularly between 1-4 years, significantly increased odds of elevated ICP, hydrocephalus, and Chiari malformation.

Conclusions:

• This study provides a national-level characterization of long-term intracranial morbidity in single suture craniosynostosis.
• Findings highlight the critical importance of suture-specific, long-term postoperative surveillance to manage potential complications.