Name of the Procedure:

Craniectomy for Craniosynostosis; Single Cranial Suture

Summary

A craniectomy for craniosynostosis is a surgical procedure where part of the skull is removed and reshaped to correct the premature fusion of a single cranial suture. This surgery helps to allow normal brain growth and correct skull shape abnormalities.

Purpose

The procedure addresses craniosynostosis, a condition where one of the sutures in a baby's skull closes prematurely, causing problems with skull and brain growth. The goals are to:

• Correct head deformities and improve appearance.
• Relieve any pressure on the brain.
• Allow the brain room to grow properly.

Indications

• Visible head deformity such as a misshapen skull.
• Increased intracranial pressure.
• Developmental delays related to cranial structure.
• Diagnosis of craniosynostosis confirmed through imaging.

Preparation

• The patient may need to fast for several hours before the surgery.
• Adjustments to medications may be required.
• Preoperative imaging studies such as CT scans or MRIs to plan the surgery.
• Blood tests and a thorough physical examination.

Procedure Description

1. General anesthesia is administered to put the patient to sleep.
2. An incision is made over the affected suture area of the scalp.
3. The surgeon carefully removes a section of the skull around the fused suture.
4. The skull bones are reshaped and sometimes repositioned.
5. The reshaped bone pieces are reattached, often using plates and screws.
6. The incision is closed with sutures or staples.

Common tools and technologies used include scalpels, surgical drills, plates, screws, and sometimes, ultrasound or endoscopic guidance.

Duration

The procedure typically takes 2 to 6 hours, depending on the complexity and extent of the surgery.

Setting

The procedure is performed in a hospital, specifically in an operating room equipped for cranial surgery.

Personnel

• Pediatric Neurosurgeon and/or Craniofacial Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating room technicians

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma.
• Injury to surrounding brain tissue.
• Anesthesia-related complications.
• Skull bone regression or need for additional surgery.
• Scarring.
• Fluid buildup under the scalp.

Benefits

• Improved skull shape and appearance.
• Alleviation of symptoms caused by increased intracranial pressure.
• Normalized brain growth and development.
• The benefits may be realized immediately, although aesthetic improvements will continue as the child grows.

Recovery

• Hospital stay for several days post-procedure.
• Pain management with prescribed medications.
• Monitoring for signs of infection or complications.
• Follow-up appointments for stitch removal and progress assessment.
• Avoiding high-impact activities for several weeks to months.
• Gradual return to normal activities based on the surgeon’s guidance.

Alternatives

• Endoscopic Strip Craniectomy: Less invasive but may require helmet therapy afterward.
• Observation and possibly non-surgical interventions: Only viable for very mild cases.
• Pros of endoscopic surgery include shorter initial recovery, while cons may include the need for long-term helmet use.

Patient Experience

• The child will be under general anesthesia and won’t feel anything during the surgery.
• Postoperative pain and discomfort managed with pain medications.
• Swelling and bruising are common but usually subside within a few weeks.
• The child may feel drowsy and irritable but will gradually return to normal behavior with proper care and support.