Outcomes after Endoscope-Assisted Strip Craniectomy and Orthotic Therapy for Syndromic Craniosynostosis

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Craniosynostosis, a condition affecting head shape due to premature suture fusion, can be syndromic in up to 24% of cases, involving genetic mutations mainly in the fibroblast growth factor receptor family. Treatment goals focus on ensuring normal head growth to prevent complications like elevated intracranial pressure. Recent data suggests endoscopic repair followed by orthotic therapy is an effective alternative to open surgery, particularly for nonsyndromic cases, due to reduced surgical times and costs.<br /><br />This study compared outcomes between syndromic and nonsyndromic craniosynostosis patients undergoing endoscopic repair, focusing on reoperation rates and patient-reported outcomes. From 2006 to 2021, 335 patients underwent endoscopic repair; 38 had syndromic craniosynostosis. The study found syndromic patients required more secondary procedures (24% compared to 2.4% in nonsyndromic patients) and had higher rates of complications like transfusions. However, cognitive outcomes were similar, though syndromic patients reported more stigma.<br /><br />The findings highlighted that although endoscopic repair is less invasive, providing benefits like shorter anesthesia time, syndromic cases might not achieve ideal aesthetic outcomes, often necessitating additional surgeries for bone growth or deformity correction. The study suggested early intervention can ameliorate neurodevelopment impacts.<br /><br />It concluded that while endoscopic repair is viable, it should be considered an adjunct in complex syndromic cases to reduce future major surgeries, emphasizing the need for individualized, ongoing management to optimize both functional and aesthetic outcomes. Further multi-institutional studies are necessary to validate this approach across different syndromic conditions.

Keywords

Craniosynostosis

Syndromic

Nonsyndromic

Endoscopic repair

Fibroblast growth factor receptor

Intracranial pressure

Orthotic therapy

Patient-reported outcomes

Neurodevelopment

Aesthetic outcomes