Craniosynostosis

Diagnosis

Specialists who do plastic and reconstructive surgery or pediatric neurosurgery must assess craniosynostosis. The following symptoms could indicate craniosynostosis:

• Physical exam. Your baby’s doctor will feel the suture ridges on its head and look for other facial anomalies like imbalanced features.
• Imaging studies. Your baby’s skull can be imaged using a Computerized Tomography (CT) scan or Magnetic Resonance Imaging (MRI) to see whether any sutures have fused. It’s possible to employ cranial ultrasound imaging. Because they become invisible when fused, fused sutures can be recognized by their absence or by a ridging of the suture line. To take exact measurements of the skull shape, laser scans and photographs may also be employed.
• Genetic testing. Genetic testing may help discover an underlying genetic condition if your healthcare professional suspects one.

Treatment

Treatment for mild cases of craniosynostosis may not be necessary. If the cranial sutures are open and the skull is misshapen. Your doctor may suggest a specially designed helmet to help reshape your baby’s head. The molded helmet in this case can help your baby’s brain develop and correct the shape of the skull.

Surgery, however, is the main form of care for the majority of infants. The kind of craniosynostosis and whether an underlying hereditary abnormality exists determine the kind of surgery to be performed and when. Multiple operations are occasionally necessary.

Surgery is performed to improve your baby’s look, minimize or avoid pressure on the brain, make space for the brain to develop normally, and correct the head shape. Both a planning procedure and surgery are involved in this.

Surgical planning

Imaging investigations can aid in the planning of surgical procedures by surgeons. High-definition 3D CT scans and MRI scans of your baby’s skull are used in virtual surgical planning for the treatment of craniosynostosis to create a customized, computer-simulated surgical plan. To help with the process, specific templates are built based on the virtual surgical plan.

Surgery

The procedure is often carried out by a team that consists of a neurosurgeon (a specialist in brain surgery) and a craniofacial surgeon (a specialist in head and face surgery). Endoscopic or open surgery can be used for surgery. Both treatments have a low risk of complications and typically generate extremely satisfactory cosmetic results.

• Endoscopic surgery. Babies up to 6 months old may be candidates for this minimally invasive procedure. Early surgery is preferred. To enable the baby’s brain to develop normally, the surgeon removes the problematic suture using an endoscope, a lit tube with a camera that is introduced through tiny scalp cuts (incisions). A smaller incision, a one-night hospital stays, and frequently no blood transfusion are all advantages of endoscopic surgery over open surgery.
• Open surgery. Open surgery is typically performed on infants older than 6 months. The afflicted area of the skull is then reshaped after the surgeon makes an incision in the scalp and cranial bones. Absorbable plates and screws are used to fix the skull position. A three-to-four-day hospital stay is customary following open surgery, and blood transfusions are frequently required. The treatment is often one-time, but in complicated situations, the baby’s head shape may need to be corrected through a series of open surgeries.

Helmet therapy

Following a minimally invasive procedure, periodic office visits are required to fit your baby with a succession of helmets that will help form his or her skull. Depending on how quickly the form reacts to treatment, the surgeon will decide how long helmet therapy should last. In most cases, no helmet is required after open surgery.