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. 2018 Mar 7:9:59.
doi: 10.4103/sni.sni_17_18. eCollection 2018.

Endoscopy-assisted craniosynostosis surgery followed by helmet therapy

H H K Delye  1 , W A Borstlap  2 , E J van Lindert  1
Affiliations

Endoscopy-assisted craniosynostosis surgery followed by helmet therapy

H H K Delye et al. Surg Neurol Int. .

Abstract

Background: Surgical methods to treat craniosynostosis have evolved from a simple strip craniectomy to a diverse spectrum of partial or complete cranial vault remodeling with excellent results but often with high comorbidity. Therefore, minimal invasive craniosynostosis surgery has been explored in the last few decades. The main goal of minimal invasive craniosynostosis surgery is to reduce the morbidity and invasiveness of classical surgical procedures, with equal long-term results, both functional as well as cosmetic.

Methods: To reach these goals, we adopted endoscopy-assisted craniosynostosis surgery (EACS) supplemented with helmet molding therapy in 2005.

Results: We present in detail our surgical technique used for scaphocephaly, trigonocephaly, plagiocephaly, complex multisutural, and syndromic cases of craniosynostosis.

Conclusions: We conclude that EACS with helmet therapy is a safe and suitable treatment option for any type of craniosynostosis, if performed at an early age, preferably around 3 months of age.

Keywords: Craniosynostosis; endoscopy; helmet; minimal invasive; surgical technique.

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Conflict of interest statement

None of the authors have any conflict of interest with publication of the manuscript or an institution or product that is mentioned in the manuscript and/or is important to the outcome of the study presented.

Figures

Figure 1
Figure 1
Instruments commonly used in EAC surgery. A: bone cutting scissors, B:small suction device, C:bended spatula for dura dissection, D: 0 degree endoscope with footplate
Figure 2
Figure 2
3D scan showing extent of craniectomy in scaphocephaly. Thick black line indicates skin incision, grey area depicts craniectomy size
Figure 3
Figure 3
3D scan showing extent of craniectomy in trigonocephaly. Thick black line indicates skin incision, grey area depicts craniectomy size
Figure 4
Figure 4
3D scan showing extent of craniectomy in plagiocephaly. Thick black line indicates skin incision, grey area depicts craniectomy size
Figure 5
Figure 5
Helmets used for orthotic treatment. Left: 2-piece thermoplastic helmet used for trigonocephaly/anterior plagiocephaly. Right: one-piece resin helmet used for scaphocephaly
Figure 6
Figure 6
(a and b) pre operative 3D fotogrammetry of a scaphocephalic patient. (c and d) 11 months postoperative 3D fotogrammetry of same patient. Frontal bossing has declined, occipital pointing is resolved, mid-parietal breadth normalized
Figure 7
Figure 7
(a and b) pre operative 3D fotogrammetry of a trigonocephalic patient. (c and d) one year postoperative 3D fotogrammetry of same patient. The width of the forehead is already increased, there is still some backslanting of the lateral brow
Figure 8
Figure 8
(a and b) pre operative 3D fotogrammetry of a patient with synostosis of left coronal and bilateral lambdoid sutures. (c and d)12 months postoperative 3D fotogrammetry of same patient. The cranial axis has almost completely aligned with the facial axis and the shape of the forehead is almost symmetrical, with perfect rounding of the occipital area
See this image and copyright information in PMC

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