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Endoscopic craniosynostosis repair is a plastic surgery procedure offered at St. Louis Children's Hospital for patients diagnosed with some types of
craniosynostosis. This innovative treatment offers many advantages to the patient and family over open craniosynostosis, including significantly shorter recovery time, smaller scars, less discomfort and swelling, and shorter hospitalizations.
Craniosynostosis is the premature fusion of one or more of the joints between the bone plates of the skull. The most frequent type of fusion is called sagittal synostosis. This premature fusion causes problems with normal brain and skull growth. Further, it increases pressure inside the head, and causes the skull or facial bones to become abnormally shaped.
Open treatment
The open treatment for craniosynostosis involves removing the deformed bone in a surgery during the first year of life, then reshaping and replacing the bone. This requires an incision over the top of the head from ear to ear, removing the bone, reshaping and securing it with dissolving plates and screws. This type of procedure normally requires a blood transfusion and a 3-6 day hospital stay with an overnight in the pediatric intensive care unit.
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Jack, a baby with craniosynostosis, undergoes endoscopic craniosynostosis surgery. Video |
Endoscopic craniosynostosis repair
This innovative procedure for the treatment of some types of craniosynostosis is offered at St. Louis Children's Hospital by Dr. Matthew D. Smyth and Dr. Albert Woo. Using a team approach to the procedure, Dr. Smyth and Dr. Woo utilize an endoscope through two small incisions measuring about 1.5 inches each at the top of the head. A segment of bone is removed near the fused bone and in a few other places which releases the fusion. No plating or reshaping are performed. Instead, in the first week after surgery, a custom molding helmet is made, which the patient wears for up to a year.
Success stories
Read about a successful endoscopic craniosynostosis procedure.
Open Craniosynostosis Repair Photo Gallery
Advantages of endoscopic craniosynostosis repair
- Decreased operative time (1.5 hours or less vs. usually about 5 hours)
- There is usually no need for a blood transfusion, and much decreased blood loss
- Shortened hospital stay: patients generally go home on day 1 or day 2
- Significantly reduced scars
- Greatly reduced discomfort and swelling
Meet the Doctors
Matthew D. Smyth, MD
Pediatric Neurosurgeon, St. Louis Children's Hospital
Director, Pediatric Epilepsy Surgery Program
Associate Professor of Neurosurgery and Pediatrics, Washington University School of Medicine
Dr. Smyth is a board-certified pediatric neurosurgeon who specializes in epilepsy and craniosynostosis. He also treats children with all types of neurosurgical disorders including brain tumors, congenital diseases, hydrocephalus, spasticity, neurofibromatosis, tuberous sclerosis, cortical dysplasia, myelomenigocele, Chiari malformation, arteriovenous malformations, spina bifida and tethered cord, and spinal and cranial trauma.
Albert Woo, MD
Pediatric Plastic Surgeon, St. Louis Children's Hospital
Chief of Pediatric Plastic Surgery and Director of the Cleft Palate & Craniofacial Institute
Associate Professor of Surgery, Washington University School of Medicine
Dr. Woo is a board-certified plastic and reconstructive surgeon who specializes in craniofacial and pediatric plastic surgery. His practice includes the treatment of cleft lip and palate disorders reconstruction for craniosynostosis and other facial/skull malformations, treatment of moles and vascular malfomations, hand surgery including fused fingers (syndactyly) and multiple fingers (polydactyly), ear reconstruction for children with abnormal or absent ears, facial trauma reconstruction, facial palsy and facial paralysis.
Kamlesh Patel, MD
Pediatric Plastic Surgeon, St. Louis Children's Hospital
Assistant Professor of Surgery, Washington University School of Medicine
Dr. Patel is a plastic and reconstructive surgeon who specializes in craniofacial and pediatric plastic surgery. His practice includes the treatment of cleft lip and palate disorders, reconstruction for craniosynostosis and other facial/skull malformations, treatment of moles and vascular malformations, ear reconstruction for children with abnormal or absent ears, and facial trauma reconstruction.
Frequently Asked Questions
How is endoscopic repair different from other methods?
Endoscopically assisted repair of craniosynostosis uses a small camera and smaller incisions to help the surgeons visualize the bone that is cut or removed during the surgery. This approach results in shorter operation times and shorter hospitalizations, but doesn't achieve as dramatic an initial correction as traditional, open, surgical techniques. Nevertheless, with the addition of molding helmet therapy, excellent cosmetic outcomes can be achieved.
Who decides which procedure is best for my child?
The decision for endoscopic versus traditional open repair resides with the parents. Both types of surgery are safe and achieve good results.
At what age should surgery be performed?
Endoscopically assisted craniosynostosis repair is usually offered to infants younger than 6 months, and as early as a few weeks of age. Better results may be achieved with earlier surgery when endoscopic techniques are used.