• World Neurosurg · Mar 2024

    Endoscopy-assisted craniosynostosis surgery without postoperative helmet molding therapy.

    • Pelayo Hevia-Rodríguez, Cristina Romero-López, Jesús Martín-Fernández, Mónica Rivero-Garvía, and Javier Márquez-Rivas.
    • Department of Neurosurgery, Donostia University Hospital, San Sebastián, Spain. Electronic address: pelahevia@gmail.com.
    • World Neurosurg. 2024 Mar 1; 183: 798579-85.

    ObjectiveEndoscopy-assisted craniosynostosis surgery (EACS) yields excellent surgical outcomes by minimizing blood loss, operative time, and hospital stays. Postoperative helmet therapy (PHT), commonly employed for head shape correction, involves frequent adjustments, potential complications, and high costs. Given the rising cost of helmet therapy, reduced insurance coverage, and limited availability in low- and middle-income countries, understanding success rates without helmet use is crucial. The present study analyses the anthropometric results of the first EACS series without PHT.MethodsA retrospective analysis of a single-center series involving 90 consecutive patients who underwent EACS without PHT from 2012 to 2022 was conducted, with a follow-up exceeding 3 years. The study exclusively included patients with nonsyndromic isolated sagittal synostosis, with 33 meeting the criteria. Craniometric measurements were obtained from preoperative, 1-year postoperative, and the latest computed tomography scans. For isolated sagittal synostosis cases, the cephalic index (CI) was calculated (CI >75 for excellent results, CI 70-75 for good results, and <70 for poor results). Collected data encompassed patient sex, age, and follow-up time.ResultsThe mean age was 84.8 ± 45.3 days (2.79 ± 1.49 months) within a range of 3-172 days. The preoperative mean CI was 68 ± 42, increasing to 76 ± 6 1 year postoperatively (mean difference +8 ± 6.3; P = 0.0001). Seventy-one percent of patients achieved excellent results, 23% good (CI = 70-75), and 6% poor. Reintervention was unnecessary.ConclusionsEACS without PHT demonstrates favorable anthropometric results, cost reduction, and simplified postoperative management.Copyright © 2023 Elsevier Inc. All rights reserved.

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