What are the steps of a craniosynostosis surgery procedure?

A craniosynostosis procedure includes the following steps:

Step 1 – Anesthesia

General anesthesia will be utilized for the duration of the surgical procedure. This will include medications for sedation and pain control. Blood and/or blood products may also be administered during the craniosynostosis surgery.

Step 2 – The incision

The incisions used for craniosynostosis surgery can be variable depending on your surgeon but typically involve an incision that extends over the top of the head from ear to ear. The incision line may be designed as a wavy line or as a zig-zag to help to "hide" the scar within the hair. A strip of hair will be shaved in the area of the incision or the entire head may be shaved depending on parent and surgeon preference.

Incisions for strip craniectomy or spring assisted craniosynostosis procedures may be more limited with a variable position based on the suture which is being treated. The incisions will still be made within the hair-bearing portions of the scalp to make the scars less noticeable after surgery.

After the incision is made, the plastic surgeon and neurosurgeon will work together to expose the fused sutures. Cuts in the bone will be performed to release the fused suture. Additional cuts in the skull bones may also be required to reshape the head and allow for ongoing expansion of the brain as your child grows. Absorbable plates, sutures or wires will be used to hold the bones in their new position.

A surgical drain may be placed at the time of the surgery to remove excess fluid from the surgical site.

Step 3 – Closing the incisions

The scalp incisions will be closed with absorbable sutures and will not need to be removed.

Step 4 – See the results

The results of open craniosynostosis surgery will be apparent immediately following the procedure with a noticeable change in the head shape. For strip craniectomy surgery, the use of a custom helmet following surgery is required to gradually mold the head into the desired shape over time. Similarly, spring assisted craniectomy surgery creates a gradual improvement in head shape as the spring slowly expands the previously fused suture.