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Craniosynostosis minimally invasive surgery holds more promise than old procedure

February 19, 2008

Craniosynostosis, the premature fusion of the skull, is estimated to affect one out of every 2,000 babies. For the past several years, physicians have used two procedures to correct the problems. One procedure was to make an incision from ear to ear, strip back the scalp of the infant and reshape the skull by breaking the bones that had fused. The other procedure required a small incision near the point of the fused skull plates. Now, the first long-term study by a researcher at the University of Missouri School of Medicine found that the minimally invasive technique is just as effective and results in a quicker recovery time than the old technique.

With craniosynostosis, two or more of the five skull plates fuse prematurely, restricting growth in the head for the brain. As the brain expands, the fused skull plates put pressure on the brain and can cause facial and skull deformities and, in some cases, brain damage.

Because the brain grows the fastest from birth to six months, it is ideal if surgeons can correct the problem as early as possible. Because of the massive amount of blood loss associated with the old technique, surgeons could not operate until the infants were between nine months and one year old. Because the new technique involves only a very small amount of blood loss, surgeons have been able to perform the surgery on babies as young as one month old.

"Instead of exposing the skull as surgeons do with the old technique, we are able to make two small incisions and remove a small strip of bone," said Usiakimi Igbaseimokumo, assistant professor of neurosurgery. "Our preliminary results in this study indicate that not only is the surgery successful in correcting the problem, but also that the procedure is as, or more, effective than the older procedure in the long term."

The study followed 78 patients who had the procedure in the last 10 years. Preliminary findings of the pilot study indicated the children were developing correctly and had good facial features. Another benefit of the new surgery is the shorter length of time the child has to be in the operating room. The minimally invasive technique only lasts about an hour, while the older technique can last as long as eight hours, Igbaseimokumo said.

Igbaseimokumo, who presented his preliminary findings at a recent meeting of the International Society of Pediatric Neurosurgeons, is will expand his study for another five to 10 years. He will be watching the children's neurological and psychological development, assessing their school reports and examining social and genetic background.

"It's very interesting that despite good results, this minimally invasive technique is not used more by surgeons around the country," Igbaseimokumo said. "We've demonstrated with our preliminary results this technique can correct the problem and help children in their neuropsychological development."

University of Missouri-Columbia