title: Surgical treatment of craniosynostosis in infants: open vs closed repair.
abstract: OBJECTIVE
  Correction of craniosynostosis may require extensive surgical interventions with related intra and postoperative complications especially hemorrhage. To reduce the intervention's impact and associated complications, less invasive surgical alternatives have evolved. The present review comprehensively summarizes surgical techniques, perioperative anesthesia management, success rates, complications, the results of outcome evaluations, and predictors of intra and postoperative complications.
  
  
  RESULTS
  Recent evaluations suggest that less invasive methods represent valuable techniques with comparable cosmetic and volumetric results but reduced overall impact and complications. Furthermore, risk stratification based on predictors might optimize safety and guide decision-making concerning the required level of postoperative clinical care.
  
  
  CONCLUSIONS
  Neuroendoscopic techniques, designed to minimize surgical incision, dissection, and blood loss, are becoming efficacious and valuable alternative therapeutic options reducing the need for fluid replacement and invasive hemodynamic monitoring. Since hemorrhage represents the most important complication in open craniosynostosis repair, prevention strategies such as the use of tranexamic acid should be considered. Sufficient correction of entailed coagulopathies is crucial.
authors.affiliation: aDepartment of Anesthesiology, University Children's Hospital beider Basel, University of Basel, Basel, Switzerland bDepartment of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Thomas O
authors.initials: TO
authors.lastname: Erb
authors.forename: Petra M
authors.initials: PM
authors.lastname: Meier
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D000074743:Hemodynamic Monitoring; D006801:Humans; D007231:Infant, Newborn; D044583:Neuroendoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D011182:Postoperative Care / Q000379:methods; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D012886:Skull / Q000601:surgery; D014148:Tranexamic Acid / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid