Craniosynostosis repair

Definition

Craniosynostosis repair is surgery to correct a problem that causes the bones of a child's skull to grow together (fuse) too early.

Alternative Names

Craniectomy - child; Synostectomy; Strip craniectomy; Endoscopy-assisted craniectomy; Sagittal craniectomy; Frontal-orbital advancement; FOA

Description

This surgery is done in the operating room under general anesthesia. This means your child will be asleep and will not feel pain.

Traditional surgery is called open repair. It includes these steps:

Surgery usually takes 3 to 7 hours. Your child will probably need to have a blood transfusion during or after surgery to replace blood that is lost during the surgery.

A newer kind of surgery is used for some children. This type is usually done for children younger than 3 to 6 months old.

Children do best when they have this surgery when they are 3 months old. The surgery should be done before the child is 6 months old

Why the Procedure Is Performed

A baby's head, or skull, is made up of many different bones. The connections between these bones are called sutures. When a baby is born, it is normal for these sutures to be open a little. This gives the baby's brain room to grow.

Craniosynostosis is a condition that causes one or more of the baby's sutures to close too early. This can cause the shape of your baby's head to be different than normal.

An x-ray or computed tomography (CT) scan can be used to diagnose craniosynostosis. Surgery is usually needed to correct it.

Surgery frees the sutures that are fused. It also reshapes the brow, eye sockets, and skull as needed. The goals of surgery are:

Risks

Risks for any surgery are:

Possible risks of having this surgery are:

Before the Procedure

If the surgery is planned, you will need to take the following steps:

During the days before the surgery:

On the day of the surgery:

Ask your doctor or nurse if your child can eat or drink before surgery. In general:

Your doctor may ask you to wash your child with a special soap on the morning of the surgery. Rinse your child well.

After the Procedure

After surgery, your child will be taken to an intensive care unit (ICU). Your child will be moved to a regular hospital room after a day or two. Your child will stay in the hospital for 3 to 7 days.

Talking, singing, playing music, and telling stories may help soothe your child. Acetaminophen (Tylenol) is used for pain. Your doctor can prescribe other pain medicines if your child needs them.

Most children who have endoscopic surgery can go home after staying in the hospital 1 night.

Outlook (Prognosis)

Most of the time, the outcome from craniosynostosis repair is good.

References

Kanev PM. Congenital malformations of the skull and meninges. Otolaryngol Clin North Am. 2007 Feb;40(1):9-26, v.

Baskin JZ. Craniofacial surgery for congenital and acquired deforminities. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 185.

Fairley JD, Sackerer D, Zeilhofer H, Sturtz G. Preliminary Experience With a Dynamic Resorbable Fixation Device for Craniosynostosis Surgery. Journal of Craniofacial Surgery, March 2012; Vol. 23 (2): pp e98–e100.


Review Date: 11/2/2012
Reviewed By: Luc Jasmin, MD, PhD, Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles and Department of Anatomy, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network.Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
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