Preliminary report on endoscopy‒assisted suturectomy for craniosynostosis

Abstract

Objective：Craniosynostosis（CS）has recently been diagnosed at an earlier age because Japanese par-ents are more conscious of their infant skull shape. Endoscopy‒assisted suturectomy（EAS）is a potential primary surgical treatment for CS in combination with postoperative helmet cranial remodeling. We report our preliminary experience with EAS for the treatment of CS. Methods：We retrospectively reviewed 7 infants with CS who underwent EAS and were fitted with custom‒made cranial helmets postoperatively. Results：Synostosis of the bilateral coronal sutures was noted in three patients；unilateral coronal suture synostosis in two patients；sagittal suture synostosis in one patient；and metopic suture synostosis in one patient. All fused sutures in these patients were removed under endoscopic support, via small scalp incisions of a few centimeters. The cranial bones were soft and cut with scissors. The average operation time was 168（range 117‒228）minutes；the average blood loss was 33.4（range 5‒87）ml. Four patients received blood transfusion. All patients were fitted with custom‒made cranial molding helmets postopera-tively. All patients experienced favorable improvements in skull shape with no mobility impairment, mor-tality, or complications, except for one patient with Pfeiffer syndrome, who did not receive helmet therapy because of a decubitus on the valve of the ventriculo‒peritoneal shunt that required additional surgery. Conclusion：EAS is minimally invasive and has yielded good results when performed in combination with helmet therapy. We will further develop the bone resection technique and hemostasis methods.