J Korean Neurosurg Soc.  2016 May;59(3):227-232. 10.3340/jkns.2016.59.3.227.

Minimally Invasive Suturectomy and Postoperative Helmet Therapy : Advantages and Limitations

Affiliations
  • 1Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea. nsthomas@snu.ac.kr

Abstract

Various operative techniques are available for the treatment of craniosynostosis. The patient's age at presentation is one of the most important factors in the determination of the surgical modality. Minimally invasive suturectomy and postoperative helmet therapy may be performed for relatively young infants, whose age is younger than 6 months. It relies upon the potential for rapid brain growth in this age group. Its minimal invasiveness is also advantageous. In this article, we review the advantages and limitations of minimally invasive suturectomy followed by helmet therapy for the treatment of craniosynostosis.

Keyword

Craniosynostosis; Suturectomy; Helmet therapy

MeSH Terms

Brain
Craniosynostoses
Head Protective Devices*
Humans
Infant

Figure

  • Fig. 1 Preoperative (A) and 1-year postoperative (B) 3D reconstructed CT views of a patient with sagittal craniosynostosis treated with minimally invasive suturectomy and postoperatihelmet therapy (left : superior view, middle : anterior view, right : lateral view). Cephalic index is 68% preoperatively and is improved to 75% 1-year after the operation.

  • Fig. 2 Preoperative (A) and postoperative follow up 3D reconstructed CT images at 2 year (B) after the minimally invasive suturectomy in a patient with left coronal craniosynostosis (left : anterior view, right : superoanterior view). Note that supraorbital asymmetry is improved in 2-year follow up images compared with the preoperative image.

  • Fig. 3 Preoperative (A) and postoperative 1-year follow up (B) 3D reconstructed CT images of a patient with left lambdoid craniosynostosis (left : posterior view, right : superoposterior view). Deformation at contralateral parietal bone and cranial base is improved at the postoperative 1-year follow up images.

  • Fig. 4 Persistent supraorbital asymmetry of patients with right coronal craniosynostosis. Compared to preoperative (A) images, asymmetry is improved but still present at postoperative 1-year follow up (B).


Reference

1. Agrawal D, Steinbok P, Cochrane DD. Long-term anthropometric outcomes following surgery for isolated sagittal craniosynostosis. J Neurosurg. 2006; 105(5 Suppl):357–360. PMID: 17328257.
Article
2. Akai T, Iizuka H, Kawakami S. Treatment of craniosynostosis by distraction osteogenesis. Pediatr Neurosurg. 2006; 42:288–292. PMID: 16902340.
Article
3. Boop FA, Chadduck WM, Shewmake K, Teo C. Outcome analysis of 85 patients undergoing the pi procedure for correction of sagittal synostosis. J Neurosurg. 1996; 85:50–55. PMID: 8683282.
Article
4. Clayman MA, Murad GJ, Steele MH, Seagle MB, Pincus DW. History of craniosynostosis surgery and the evolution of minimally invasive endoscopic techniques : the University of Florida experience. Ann Plast Surg. 2007; 58:285–287. PMID: 17471133.
Article
5. Denis D, Genitori L, Bolufer A, Lena G, Saracco JB, Choux M. Refractive error and ocular motility in plagiocephaly. Childs Nerv Syst. 1994; 10:210–216. PMID: 7923229.
Article
6. Eppley BL, Sadove AM, Havlik RJ. Resorbable plate fixation in pediatric craniofacial surgery. Plast Reconstr Surg. 1997; 100:1–7. discussion 8-13. PMID: 9207653.
Article
7. Esparza J, Hinojosa J. Complications in the surgical treatment of craniosynostosis and craniofacial syndromes : apropos of 306 transcranial procedures. Childs Nerv Syst. 2008; 24:1421–1430. PMID: 18769932.
Article
8. Faber HK, Towne EB. Early craniectomy as a preventive measure in oxycephaly and allied conditions. Am J Med Sci. 1927; 173:701–711.
Article
9. Faberowski LW, Black S, Mickle JP. Blood loss and transfusion practice in the perioperative management of craniosynostosis repair. J Neurosurg Anesthesiol. 1999; 11:167–172. PMID: 10414670.
Article
10. Fearon JA, Weinthal J. The use of recombinant erythropoietin in the reduction of blood transfusion rates in craniosynostosis repair in infants and children. Plast Reconstr Surg. 2002; 109:2190–2196. PMID: 12045535.
Article
11. Heller JB, Heller MM, Knoll B, Gabbay JS, Duncan C, Persing JA. Intracranial volume and cephalic index outcomes for total calvarial reconstruction among nonsyndromic sagittal synostosis patients. Plast Reconstr Surg. 2008; 121:187–195. PMID: 18176220.
Article
12. Hinojosa J, Esparza J, Muñoz MJ. Endoscopic-assisted osteotomies for the treatment of craniosynostosis. Childs Nerv Syst. 2007; 23:1421–1430. PMID: 17899127.
Article
13. Jimenez DF, Barone CM. Early treatment of anterior calvarial craniosynostosis using endoscopic-assisted minimally invasive techniques. Childs Nerv Syst. 2007; 23:1411–1419. PMID: 17899128.
Article
14. Jimenez DF, Barone CM. Early treatment of coronal synostosis with endoscopy-assisted craniectomy and postoperative cranial orthosis therapy : 16-year experience. J Neurosurg Pediatr. 2013; 12:207–219. PMID: 23808724.
Article
15. Jimenez DF, Barone CM. Endoscopic craniectomy for early surgical correction of sagittal craniosynostosis. J Neurosurg. 1998; 88:77–81. PMID: 9420076.
Article
16. Jimenez DF, Barone CM. Endoscopic technique for sagittal synostosis. Childs Nerv Syst. 2012; 28:1333–1339. PMID: 22872245.
Article
17. Jimenez DF, Barone CM. Intraoperative autologous blood transfusion in the surgical correction of craniosynostosis. Neurosurgery. 1995; 37:1075–1079. PMID: 8584147.
Article
18. Jimenez DF, Barone CM. Multiple-suture nonsyndromic craniosynostosis : early and effective management using endoscopic techniques. J Neurosurg Pediatr. 2010; 5:223–231. PMID: 20192637.
Article
19. Jimenez DF, Barone CM, McGee ME, Cartwright CC, Baker CL. Endoscopy-assisted wide-vertex craniectomy, barrel stave osteotomies, and postoperative helmet molding therapy in the management of sagittal suture craniosynostosis. J Neurosurg. 2004; 100(5 Suppl Pediatrics):407–417. PMID: 15287447.
Article
20. Kearney RA, Rosales JK, Howes WJ. Craniosynostosis : an assessment of blood loss and transfusion practices. Can J Anaesth. 1989; 36:473–477. PMID: 2758548.
Article
21. Kumar AV, Staffenberg DA, Petronio JA, Wood RJ. Bioabsorbable plates and screws in pediatric craniofacial surgery : a review of 22 cases. J Craniofac Surg. 1997; 8:97–99. PMID: 10332274.
22. Lannelongue M. De la craniectomie dans la microcéphalie. Compt Rend Seances Acad Sci. 1890; 50:1382–1385.
23. Macintosh C, Wall S, Leach C. Strabismus in unicoronal synostosis : ipsilateral or contralateral? J Craniofac Surg. 2007; 18:465–469. PMID: 17538304.
24. MacKinnon S, Rogers GF, Gregas M, Proctor MR, Mulliken JB, Dagi LR. Treatment of unilateral coronal synostosis by endoscopic strip craniectomy or fronto-orbital advancement : ophthalmologic findings. J AAPOS. 2009; 13:155–160. PMID: 19393513.
Article
25. Marsh JL, Jenny A, Galic M, Picker S, Vannier MW. Surgical management of sagittal synostosis. A quantitative evaluation of two techniques. Neurosurg Clin N Am. 1991; 2:629–640. PMID: 1821309.
26. Maugans TA, McComb JG, Levy ML. Surgical management of sagittal synostosis : a comparative analysis of strip craniectomy and calvarial vault remodeling. Pediatr Neurosurg. 1997; 27:137–148. PMID: 9548524.
Article
27. Murad GJ, Clayman M, Seagle MB, White S, Perkins LA, Pincus DW. Endoscopic-assisted repair of craniosynostosis. Neurosurg Focus. 2005; 19:E6. PMID: 16398483.
Article
28. Panchal J, Marsh JL, Park TS, Kaufman B, Pilgram T, Huang SH. Sagittal craniosynostosis outcome assessment for two methods and timings of intervention. Plast Reconstr Surg. 1999; 103:1574–1584. PMID: 10323690.
Article
29. Persing J, Babler W, Winn HR, Jane J, Rodeheaver G. Age as a critical factor in the success of surgical correction of craniosynostosis. J Neurosurg. 1981; 54:601–606. PMID: 7014791.
Article
30. Proctor MR. Endoscopic craniosynostosis repair. Transl Pediatr. 2014; 3:247–258. PMID: 26835342.
31. Ridgway EB, Berry-Candelario J, Grondin RT, Rogers GF, Proctor MR. The management of sagittal synostosis using endoscopic suturectomy and postoperative helmet therapy. J Neurosurg Pediatr. 2011; 7:620–626. PMID: 21631199.
Article
32. Rivero-Garvía M, Marquez-Rivas J, Rueda-Torres AB, Ollero-Ortiz A. Early endoscopy-assisted treatment of multiple-suture craniosynostosis. Childs Nerv Syst. 2012; 28:427–431. PMID: 22038155.
Article
33. Seymour-Dempsey K, Baumgartner JE, Teichgraeber JF, Xia JJ, Waller AL, Gateno J. Molding helmet therapy in the management of sagittal synostosis. J Craniofac Surg. 2002; 13:631–635. PMID: 12218789.
Article
34. Shah MN, Kane AA, Petersen JD, Woo AS, Naidoo SD, Smyth MD. Endoscopically assisted versus open repair of sagittal craniosynostosis : the St. Louis Children's Hospital experience. J Neurosurg Pediatr. 2011; 8:165–170. PMID: 21806358.
Article
35. Shillito J Jr, Matson DD. Craniosynostosis : a review of 519 surgical patients. Pediatrics. 1968; 41:829–853. PMID: 5643989.
36. Sugawara Y, Hirabayashi S, Sakurai A, Harii K. Gradual cranial vault expansion for the treatment of craniofacial synostosis : a preliminary report. Ann Plast Surg. 1998; 40:554–565. PMID: 9600446.
Article
37. Tan SP, Proctor MR, Mulliken JB, Rogers GF. Early frontofacial symmetry after correction of unilateral coronal synostosis : frontoorbital advancement vs endoscopic strip craniectomy and helmet therapy. J Craniofac Surg. 2013; 24:1190–1194. PMID: 23851767.
Article
38. Whitaker LA, Bartlett SP, Schut L, Bruce D. Craniosynostosis : an analysis of the timing, treatment, and complications in 164 consecutive patients. Plast Reconstr Surg. 1987; 80:195–212. PMID: 3602170.
39. White N, Evans M, Dover MS, Noons P, Solanki G, Nishikawa H. Posterior calvarial vault expansion using distraction osteogenesis. Childs Nerv Syst. 2009; 25:231–236. PMID: 19057909.
Article
40. Zubovic E, Woo AS, Skolnick GB, Naidoo SD, Smyth MD, Patel KB. Cranial base and posterior cranial vault asymmetry after open and endoscopic repair of isolated lambdoid craniosynostosis. J Craniofac Surg. 2015; 26:1568–1573. PMID: 26114505.
Article
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