# Craniosynostosis: Experience From a Single Tertiary Center in India

## TL;DR

This paper reports on surgical outcomes for craniosynostosis in Indian patients, finding that extensive procedures yield better results than simpler ones.

## Contribution

The study provides empirical evidence from an Indian tertiary center comparing surgical outcomes for craniosynostosis.

## Key findings

- Extensive procedures like FBR with FOA and TCVR showed significantly better outcomes than suturectomies.
- Head circumference increased significantly post-operation (from 42.85 cm to 44.73 cm).
- Parent satisfaction and surgical outcome scores improved significantly with extensive procedures.

## Abstract

Introduction

Premature fusion of one or more cranial sutures results in a diverse set of conditions collectively known as craniosynostosis. It is primarily responsible for cosmetic issues and occasionally associated with complications like brain growth restriction, raised intracranial pressure (ICP), and blindness. Management ranges from conservative surgical procedures such as suturectomies to more extensive procedures, including frontal bone remodeling with fronto-orbital advancement (FBR with FOA) and total calvarial reconstructions (TCVR). Currently, there is no consensus on an ideal procedure for a particular type of surgery for this condition.

Methods

A retrospective review of 26 consecutive patients treated at a single tertiary center in India was performed. Sloan's surgical outcome class and parent satisfaction score to compare different forms of intervention. Transfusion requirements, length of hospital, and increase in head circumference post-operation were also used.

Results

The mean age in our cohort was 10.9 months, with a ratio of 9:4 male-to-female. The overall assessment of pre- vs. post-operative head circumference revealed a strong significant mean improvement from 42.85 cm to 44.73 cm (p<0.001). A comparison of measured variables for all 26 patients revealed a significant difference in Sloan's surgical outcomes class (5.4 vs 1.2, p<0.001), Parent satisfaction score (5.1 vs 9.1, p<0.001) and increase in head circumference (cm) post-operation (0.74 vs 2.39, p<0.001) when comparing suturectomies vs extensive procedure like FBR with FOA and TCVR.

Conclusion

Our results favored FBR with FOA and TCVR over simple suturectomies for more satisfactory and long-lasting results with acceptable mortality and morbidity.