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Surgery for Craniosynostosis

Surgery is the only effective treatment for craniosynostosis, because fused sutures must be opened to allow the brain to expand. This is not something that will happen naturally, and a child cannot “outgrow” craniosynostosis. A skilled surgeon must create new openings in the skull to allow for the rapid brain growth that takes place in the first year of life. The surgery is very safe and produces excellent results.

There are several surgical options for treating craniosynostosis, depending on which type it is. It’s usually best to perform surgery at just a few weeks to a few months of age, since the skull bones are the softest and most malleable then. The craniofacial team that evaluates a child will recommend the best surgery based on which suture closed prematurely and the degree of deformity. 

Traditional open surgical procedures are called cranial vault remodeling and vertex craniectomy, which are extremely safe and produce excellent results. In this surgery, a neurosurgeon removes the affected or closed suture and then “remodels” the skull. The surgery usually takes between two and six hours and requires three to five days in the hospital, depending on the age of the child and which suture is involved. Some children need blood transfusions during the surgery; a compatible parent may donate his or her blood to be used in the event that a transfusion is needed. No helmet therapy is needed after traditional surgery.  

Endoscopically assisted strip craniectomy (also called endoscopic assisted suturectomy) is a newer, minimally invasive approach to craniosynostosis surgery. As in the traditional approach, a neurosurgeon removes the closed suture – but unlike the traditional approach, the endoscopic procedure does not include cranial remodeling during surgery. This minimally invasive procedure is typically performed on infants younger than three months of age, since it depends on extremely rapid brain growth to help reposition the cranial bones. Endoscopic assisted suturectomy usually takes less time in the operating room and requires a shorter hospital stay. After endoscopic surgery for craniosynostosis, the child will wear a cranial remodeling helmet to help reshape the skull. Find out more about minimally invasive endoscopic surgery for craniosynostosis.

With all corrective forms of treatment, brain function and development are expected to be normal and there are no special precautions or significant limitations on activities. 

Find out more about the multidisciplinary Craniofacial Program at the Weill Cornell Pediatric Brain and Spine Center, or use our online form to request an appointment for a consultation or second opinion.

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Reviewed by: Mark M. Souweidane, M.D.
Last reviewed/last updated:  January 2019


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