Efficacy of endoscopic strip craniectomy for sagittal synostosis

Abstract

Objective To explore the clinical effect of endoscopic strip craniectomy with orthotic skull helmet for sagittal synostosis. Methods A total of 20 children with sagittal synostosis admitted to Shanghai Children's Hospital from June 2019 to June 2022 were included. All of them underwent endoscopic strip craniectomy and customized orthotic skull helmet assisted treatment after the surgery. Cephalic index (CI) and point of maximum width (PMW) were calculated by measuring transverse diameter of skull, anterior and posterior diameter of skull, and distance between eyebrow and transverse diameter of skull. Results All 20 sagittal synostosis children successfully completed the surgery, the success rate of the surgery was 100%, and no indwelling drainage tube was placed in the surgical area. There were no postoperative complications such as bone flap displacement, cerebrospinal fluid leakage, secondary infection, nerve function defect caused by skull osteotomy and secondary injury caused by bone fragments ionization. At 6 months after sugery and last follow⁃up, 19 children showed a favorable prognosis in terms of cranial shape, while one 2⁃month⁃old female child had an unfavorable head shape prognosis (CI was 72% at 6 months after sugery, and 74% at the last follow⁃up). There were statistically significant differences between CI (F = 230.542, P = 0.000) and PMW (F = 112.166, P = 0.000) before and after surgery. Among them, CI (t = ⁃ 14.231, P = 0.000; t = ⁃ 21.041, P = 0.000) and PMW (t = ⁃ 8.068, P = 0.000; t = ⁃ 16.109, P = 0.000) at 6 month after surgery and last follow⁃up were higher than those before surgery. CI (t = ⁃ 6.810, P = 0.000) and PMW (t = ⁃ 8.040, P = 0.000) at last follow⁃up were higher than those at 6 month after surgery. Conclusions Endoscopic strip craniectomy with orthotic skull helmet can improve the cranial shape of children with sagittal synostosis and is considered safe and effective.

DOI: 10.3969/j.issn.1672⁃6731.2023.07.010