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Outcomes of the early endoscopic-assisted suturectomy for treatment of multisuture craniosynostosis

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Abstract

To present the outcomes and adverse events associated with the endoscopic-assisted, minimally invasive suturectomy in patients with multisuture synostosis. This retrospective cohort study included children < 65 days of age who underwent endoscopic-assisted suturectomy (EAS) for multisuture craniosynostosis at a single tertiary referral center from 2013 to 2021. The primary outcome was calvarial expansion, and the secondary outcome was adverse events. The pre- and post-operative 3-dimensional brain computed tomography (CT) scan was used to calculate the intracranial volume and cephalic index. During a period of 2 years, 10 infants (10–64 days) diagnosed with multisuture synostosis underwent single-stage EAS of every affected suture in our center. The coronal suture was the most prevalent involved suture among our cases. The mean age and weight of the patients were 39 ± 17.5 days and 4.39 ± 0.8 kg, respectively. The surgical procedure took 42 ± 17.4 min of time and caused 46 ± 25.4 mL of bleeding on average. Ninety percent of the operations were considered successful (n = 9) regarding calvarial expansion. There were two complications, one requiring an open vault surgery and one repairing a leptomeningeal cyst. In the eight patients who did not necessitate further interventions, the mean pre-operative intracranial volume was 643.3 ± 189.4 cm3. The follow-up results within the average of 38.9 months after surgery showed that as age increases, the intracranial volume also increased significantly (R: 0.6, P < 0.0001), which suggests continued skull growth in patients who underwent EAS. With the low rate of intra- or post-operative complications and promising results on revising the restricted skull sutures, EAS seems both a safe and effective therapeutic modality in patients with multisuture synostosis, especially if completed in the first months after birth.

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Authors and Affiliations

  1. Pediatric Neurosurgery Research Center, Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Omid Yousefi, Reza Taheri, Amirmohamad Farrokhi, Sina Zoghi, Arash Jamshidi & Mohammad Sadegh Masoudi

  2. Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA

    Mohammadmahdi Sabahi

  3. Department of Neurosurgery, University of Iowa Hospitals & Clinics, Iowa City, IA, USA

    Rebecca A. Reynolds

  4. Division of Plastic Surgery, Department of General Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Mohammad Ali Hoghoughi

  5. Department of Neurosurgery, Dell Medical School, The University of Texas, Austin, TX, USA

    M. Omar Iqbal

  6. Department of Neurosurgery, Johns Hopkins Medicine, Institute for Brain Protection Sciences, Johns Hopkins All Children’s Hospital, St. Petersburg, FL, USA

    George I. Jallo

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  1. Omid Yousefi
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Contributions

OY, RT, and MS: preparation of primary draft.

AF, SZ, and AJ: data collection.

MH, MM: initial idea and supervision.

RR, OI, and GJ: supervision on manuscript preparation and final review.

Corresponding author

Correspondence to Mohammad Sadegh Masoudi.

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Ethics approval and consent to participate

The ethics committee of Shiraz University of Medical Sciences waived ethical approval due to the retrospective nature of the study and the fact that all interventions and follow-ups were part of routine care. At the time of the operation, each participant provided written informed consent for participation and publication.

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The authors declare no competing interests.

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Yousefi, O., Taheri, R., Sabahi, M. et al. Outcomes of the early endoscopic-assisted suturectomy for treatment of multisuture craniosynostosis. Neurosurg Rev 46, 289 (2023). https://doi.org/10.1007/s10143-023-02191-1

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  • DOI: https://doi.org/10.1007/s10143-023-02191-1

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