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Craniosynostosis repair

Contents of this page:

Alternative Names   

Craniectomy; Synostectomy; Strip craniectomy; Endoscopy-assisted craniectomy; Sagittal craniectomy; Frontal-orbital advancement; FOA

Definition    Return to top

Craniosynostosis repair is surgery to fix damage caused by a birth defect that makes the bones in a child’s skull grow together too early.

Description    Return to top

A baby's head, or skull, is made up of many different bones. The connections between these bones are called sutures. When a baby is born, it is normal for these sutures to be open a little. This gives the baby’s brain and head room to grow.

Your baby was born with craniosynostosis, a condition that caused 1 or more of your baby’s sutures to close too early. This can cause the shape of your baby’s head to be different than normal. Sometimes it can cause brain damage.

An x-ray or computed tomography (CT scan) can be used to diagnose craniosynostosis. Surgery is usually needed to correct it. This surgery is performed in the operating room under general anesthesia (your child will be asleep and will not feel pain).

Traditional surgery is called open repair. It includes these steps:

Surgery usually takes 3 to 7 hours. Your child will probably need to have a blood transfusion during or after surgery to replace blood that is lost during the surgery.

A newer kind of surgery is used for some children. This type is usually done for children younger than 3 to 6 months old.

Children do best when they have this surgery when they are 3 months old. The surgery should be done before the child is 6 months old

Why the Procedure is Performed    Return to top

Surgery frees the sutures that are fused. It also reshapes the brow, eye sockets, and skull as needed. The goals of surgery are:

Risks    Return to top

Risks for any surgery are:

Possible risks of having this surgery are:

Before the Procedure    Return to top

For a planned surgery (not an emergency), you will need to prepare your child.

During the days before the surgery:

On the day of the surgery:

Ask your doctor or nurse about your child’s eating and drinking before the surgery. General guidelines are:

Your doctor may ask you to wash your child with a special soap on the morning of the surgery. Rinse your child well afterwards.

After the Procedure    Return to top

After the open surgery, your child will be taken to an intensive care unit (ICU). After 1 or 2 days, your child will be moved to a regular hospital room. Your child will stay in the hospital for 3 to 7 days.

Talking and singing to the child, and playing music and telling stories, may help soothe them. Acetaminophen (Tylenol) is used for pain, but your nurse will have other pain medicines if your child needs them.

Most children who have endoscopic surgery can go home after staying in the hospital 1 night.

Outlook (Prognosis)    Return to top

Most times, craniosynostosis repair is successful and allows your child’s skull and brain to develop normally.

References    Return to top

Kanev PM. Congenital malformations of the skull and meninges. Otolaryngol Clin North Am. 2007 Feb;40(1):9-26, v.

Baskin JZ, Tatum III, SA. Craniofacial surgery for congenital and acquired deforminities. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia, Pa: Mosby Elsevier; 2005:chap 175.

Update Date: 12/7/2008

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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