Age at referral for sagittal suture synostosis: a decreasing trend in 20 years

Early referral of patients with suspected sagittal suture synostosis is important as it enables minimally invasive surgery. To encourage early referrals, the authors' craniofacial center has increased its efforts to educate referring healthcare providers. This study evaluated the developments of timely referral and age at referral of patients with sagittal suture synostosis.

Nonsyndromic patients born between 2000 and 2020 were included in this cohort study. The type of surgery was mainly based on age at referral: frontobiparietal remodeling was done if the patient was older than 6 months of age, and a minimally invasive procedure was done if the patient was younger. Logistic regression was performed to assess the relationship between the year of birth and the probability of a timely first visit (i.e., before 5.5 months).

A total of 698 patients were included, with a median age at first visit of 3.6 months. Of the patients born in 2000, 60% had their first visit before the age of 5.5 months, compared to 77% of those born in 2020. Since 2010, there has been a statistically significant positive association between the year of birth and the probability of having the first visit on time (OR 1.10, 95% CI 1.03-1.18). Overall, pediatricians were the most frequent referrers.

The proportion of timely referred patients with nonsyndromic sagittal suture synostosis has increased over the past 20 years, and since 2010, there has been a statistically significant increase in the probability of timely referral, allowing for more patients to be treated with minimally invasive spring-assisted correction. Further efforts are needed to increase timely referrals and raise awareness among parents and healthcare providers.