The treatment of craniosynostosis is surgical. In a small percentage of cases, surgery is mandated by an increase in intracranial pressure due to changes in head shape, configuration and volume. However, most cases are treated because of the resulting aesthetic deformities, and the team efforts of a craniofacial plastic surgeon and neurosurgeon can optimize the cosmetic outcome. Rady Children’s surgeons are well known for their ability to work with pediatric neurosurgeons in achieving the best appearance for each child.
Reasons for Treatment:
- Increased intracranial pressure
- Eye protection
- Airway protection
- Disfigurement
What are My Child’s Treatment Options?
- In mild cases, your child can be followed closely.
- In most cases, because the deformity is progressive, surgical treatment is recommended.
What are the Surgical Options?
- One is an open approach, in which the incision is hidden in the hair and goes from ear to ear. This is the traditional approach and involves a team of craniofacial and pediatric neurosurgeons. The abnormal suture is opened and the bones are surgically repositioned and held in place with resorbable devices.
- A second is an endoscopic or minimally invasive approach. Children who have undergone endoscopy (including at our endoscopy suites) will also often be prescribed helmet or band therapy for the first year after surgery to further correct the shape of the head. This therapy involves taking a plaster impression of the skull, which is then rounded out. A form-fitting helmet or band is made and sits snugly on the prominent areas of the head but allows the recessed and flattened portions to gradually expand into the open areas of the helmet, molding the head as it grows. Depending on the child’s age, correction in skull shape usually occurs within three to six months. The helmet or band is made by a skilled orthotist working with the craniofacial surgeon and/or a pediatric neurosurgeon or pediatrician.
For position-related head deformities, craniofacial surgery is necessary in only a few patients with especially pronounced deformities not covered by the hair. For children with severe deformations around the forehead and eyes, craniofacial surgery may also be necessary. This surgery is similar to that performed for craniosynostosis.