Endoscopically assisted craniosynostosis surgery (EACS): The craniofacial team Nijmegen experience.
BACKGROUND
An evaluation of our first 111 consecutive cases of non-syndromic endoscopically assisted craniosynostosis surgery (EACS) followed by helmet therapy.


METHODS
Retrospective analysis of a prospective registration database was performed. Age, duration of surgery, length of hospital stay, blood loss, transfusion rate, cephalic index and duration of helmet therapy were evaluated. An online questionnaire was used to evaluate the burden of the helmet therapy for the child and parents.


RESULTS
111 EAC procedures were performed: 64 for scaphocephaly, 34 for trigonocephaly and13 for anterior plagiocephaly. The mean age at the time of surgery was 3.9 (±1) months, mean surgical time was 58 (±18) minutes, mean blood loss was 34 (±28) ml, transfusion rate was 22% (n = 26), mean duration of postoperative helmet therapy was 10 (±2.5) months, mean preoperative and postoperative CI were respectively 0.67(±0.057) and 0.72 (±0.062) in scaphocephalic patients and the mean length of hospital stay was 2.6 (±1) days. The burden of the helmet therapy for the child and his family was deemed very low.


CONCLUSIONS
EACS for non-syndromic patients shows low morbidity rates, short surgical time, short length of hospital stay, little blood loss and low need for blood transfusion and is associated with satisfying cosmetic results.
Department of Neurosurgery, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands. Electronic address: Hans.Delye@radboudumc.nl.
Hans Hendrik Karel
HH
Delye
Department of Neurosurgery, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Sebastian
S
Arts
Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Wilfred Ary
WA
Borstlap
Department of Anesthesiology, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Laura Mirjam
LM
Blok
Department of Anesthesiology, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Jacques Jan
JJ
Driessen
Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands; 3D Facial Imaging Research Group Nijmegen, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Jene Willem
JW
Meulstee
Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands; 3D Facial Imaging Research Group Nijmegen, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Thomas Jan Jaap
TJ
Maal
Department of Neurosurgery, Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Erik Jan
EJ
van Lindert
D016063:Blood Loss, Surgical; D003393:Cranial Sutures / Q000601:surgery; D003398:Craniosynostoses / Q000601:surgery* / Q000628:therapy; D003399:Craniotomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D006260:Head Protective Devices; D006801:Humans; D007223:Infant; D007902:Length of Stay; D061646:Operative Time; D011182:Postoperative Care; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery*; D011795:Surveys and Questionnaires
Craniosynostosis; Endoscopy; Helmet; Minimal invasive; Stereo-photogrammetry; Surgical technique