Craniosynostosis: Clinical Presentation and Outcome of Surgical Treatment

Abstract

Objective:  Craniosynostosis presents sclerosis cranial sutures, ossification and fusion involving the vault of the base, sutures involved can be one or more sutures. This study aimed to determine the surgical outcome of craniosynostosis.

Material and Method:  The prospective study was conducted at the neuro spinal and cancer care institute, Karachi. Patients presented with sagittal, metopic, unicoronal, lambdoid, bicoronal craniosynostosis were included in the study, while patients with coagulopathy, previously operated cases were excluded from the study.

Results:  We had 26 children in our study, age range about 1–3 years. Patients were cleaved into groups depending on their age. Most of the children 15 (57.6%) were in 1–2 years age group and 11 (42.3%) were in 2-3 years of age. Boys were 18 (69.2%) and girls were 8(30.7%). Coronal 11 (42.3%) was the most common suture involved, followed by sagittal 9 (34.6%). Lambdoid suture 3 (11.5%), metopic 2 (7.6%) and 3 (11.5%) case presented with raised intracranial pressure with multiple sutures closed involved. Strip craniectomy was done in all cases. We did bicoronal flap and Scalp flap turned into a supraorbital region while in metopic suture Fronto-orbital advancement and remodeling approach were used. No major complication was observed.

Conclusion:  Cases which are managed early age have given good acceptable results in follow up, proper surgical expertise, perioperative management of temperature, blood loss, relieving the restriction of sutures and normalizing raised intracranial pressure can decrease the morbidity and mortality.