Endoscopic-assisted osteotomies for the treatment of craniosynostosis
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The development of multidisciplinar units for Craniofacial Surgery has led to better postoperative results and a considerable decrease in morbidity in the treatment of complex craniofacial patients.
Materials and methods
Standard correction of craniosynostosis involves calvarial remodeling, often considerable blood losses that need to be replaced and lengthy hospital stay. The use of minimally invasive techniques for the correction of some of these malformations are widespread and allows the surgeon to minimize the incidence of complications by means of a decreased surgical time, blood salvage, and shortening of postoperative hospitalization in comparison to conventional craniofacial techniques.
Discussion and conclusion
Simple and milder craniosynostosis are best approached by endoscopy-assisted osteotomies and render the best results. Extended procedures other than simple suturectomies have been described for more severe patients. Different osteotomies resembling standard fronto-orbital have been developed for the correction, and the use of postoperative cranial orthesis may improve the final cosmetic appearance. Thus, endoscopic-assisted procedures differ from the simple strategy of single suture resection that rendered insufficient results in the past, and different approaches can be tailored to solve these cases in patients in the setting of a case-to-case bases.
KeywordsEndoscopic surgery Minimally invasive surgery Craniosynostosis Craniectomies Surgical technique
We thank David Jimenez, M.D., FAAP, FACS and Constance Barone, FAAP, FACS for sharing their techniques and expert advice. Many of their indications allowed our patients to benefit from decreased blood losses and improved cosmetic results.
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