Minimally invasive craniectomy and postoperative cranial remolding orthotic treatment in infants with craniosynostosis: A multicenter prospective study

Abstract

Objective: To investigate the effectiveness of minimally invasive suturectomy (MIS) with cranial remolding orthosis (CRO) for treatment of patients with single-suture craniosynostosis. Methods: In this multicenter prospective study, all patients included underwent MIS followed by postoperative CRO. The values of the cephalic index (CI) and cranial vault asymmetry index (CVAI) were measured and recorded before the surgery, at initiation of CRO, and at the cessation of CRO. The total cranial volume (TV), anterior hemisphere cranial volume (AV), and AV to TV were also acquired with a non-contact optical scanner. All patients were followed up at least until the end of the twelfth month of age. Results: A total of 38 patients were included. The average operative time including anesthesia was 95.38 minutes. The average length of hospital admission was 2.5 days. There was a statistically significant difference in CI values for the patients with sagittal craniosynostosis (p < 0.05). The improvement in CVAI values were statistically significant in all three groups of participants (p < 0.001). The AV and TV from initiation to cessation of CRO treatment were statistically significant in all three groups of participants (p < 0.001). Regarding the AV to TV ratio, there was a significant difference from initiation to the cessation of CRO treatment in sagittal and metopic groups of participants (p < 0.05). The average daily hours of CRO wearing was 18.54 hours. Conclusions: The findings of this investigation complement those of earlier studies and showed that MIS with CRO treatment is a good strategy with satisfactory results for patients with single-suture craniosynostosis.

Keywords

• Craniosynostosis
• Minimal invasive
• Endoscopic
• Cranial remolding orthosis
• Orthotic treatment
• Cephalic index