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Background <p>Premature closure of the sagittal suture (scaphocephaly) is the most frequent form of craniosynostosis, with an incidence of ca. 1&#xa0;in 5000 live births. If left untreated it results in a characteristic elongated cranial shape with risks of impaired cerebral growth and disturbed intracranial pressure. Correction has traditionally relied on open cranial vault remodelling at 6–12&#xa0;months of age. Over the past two decades, however, endoscope-assisted techniques have become available, providing a&#xa0;minimally invasive alternative associated with more favorable perioperative and postoperative outcomes due to the lower access trauma. Early diagnosis and referral are crucial.</p> Methods <p>Following the introduction of endoscope-assisted sagittal suturectomy in 2020, we retrospectively compared 16&#xa0;infants treated with this minimally invasive technique to 16&#xa0;who underwent conventional open surgery. The primary endpoints were the perioperative parameters duration of surgery, blood loss, transfusion requirements, postoperative soft tissue edema, duration of intensive care unit (ICU) stay and clinical course.</p> Results <p>The mean age at surgery was lower in the endoscopy group (4&#xa0;months) than in the open group (6&#xa0;months). The minimally invasive endoscopic repair was associated with shorter operation times and less transfusions, periorbital swelling and ICU stay were reduced, while children in the open group required more red blood cells (<i>p</i> = 0.09). However, at 12&#xa0;months both groups achieved comparable normalization of cranial shape.</p> Discussion <p>Our findings confirm the advantages of endoscopic sagittal synostosis repair described in the literature: reduced perioperative burden with equal long-term safety; however, a prerequisite is surgery timing at 3–6&#xa0;months. Beyond this, or in cases of complex synostosis, open remodelling remains standard. Overall, when performed early the endoscope-assisted technique is a&#xa0;safe, effective and less invasive alternative to open correction.</p>

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Offene vs. endoskopisch-assistierte Operationsmethode bei Scaphocephalus

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月17日

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  • Selina Neurauter,
  • Carina Harasser,
  • Johanna Astrid Moser-Rumer,
  • Agnese Nitto,
  • Evi M. Morandi,
  • Anton Schwabegger

摘要

Background

Premature closure of the sagittal suture (scaphocephaly) is the most frequent form of craniosynostosis, with an incidence of ca. 1 in 5000 live births. If left untreated it results in a characteristic elongated cranial shape with risks of impaired cerebral growth and disturbed intracranial pressure. Correction has traditionally relied on open cranial vault remodelling at 6–12 months of age. Over the past two decades, however, endoscope-assisted techniques have become available, providing a minimally invasive alternative associated with more favorable perioperative and postoperative outcomes due to the lower access trauma. Early diagnosis and referral are crucial.

Methods

Following the introduction of endoscope-assisted sagittal suturectomy in 2020, we retrospectively compared 16 infants treated with this minimally invasive technique to 16 who underwent conventional open surgery. The primary endpoints were the perioperative parameters duration of surgery, blood loss, transfusion requirements, postoperative soft tissue edema, duration of intensive care unit (ICU) stay and clinical course.

Results

The mean age at surgery was lower in the endoscopy group (4 months) than in the open group (6 months). The minimally invasive endoscopic repair was associated with shorter operation times and less transfusions, periorbital swelling and ICU stay were reduced, while children in the open group required more red blood cells (p = 0.09). However, at 12 months both groups achieved comparable normalization of cranial shape.

Discussion

Our findings confirm the advantages of endoscopic sagittal synostosis repair described in the literature: reduced perioperative burden with equal long-term safety; however, a prerequisite is surgery timing at 3–6 months. Beyond this, or in cases of complex synostosis, open remodelling remains standard. Overall, when performed early the endoscope-assisted technique is a safe, effective and less invasive alternative to open correction.