What is endoscopic strip craniectomy?

Endoscopic strip craniectomy

Endoscopic strip craniectomy is a minimally invasive procedure that is used to treat craniosynostosis. The operation is performed under a general anaesthetic through small scalp incisions about 3cm long.  The exact location and number of incisions depend on the type of craniosynostosis and the individual suture that is affected. Often only one incision is required and this is hidden within the hair.

Your craniofacial surgeon will be able to explain where these will be for your baby. A small strip of bone is then carefully removed from the area where the fused suture (craniosynostosis) is. As this operation is performed within the first few months of life, the growth of the brain and skull can be guided by a helmet back into a more regular shape.

What age is best for this type of surgery

Babies less than six months of age seem to gain the most benefit most from this procedure. If you suspect that your child has craniosynostosis, or are concerned about their head shape, you should request a referral from your GP or paediatrician to be seen by a craniofacial surgeon as soon as possible.

What type of craniosynostosis can be treated with this condition?

Endoscopic strip craniectomy has been used to treat craniosynostosis of the metopic, sagittal, coronal and lambdoid sutures. It is also suitable for some children with more than one suture affected.

How long will my baby be in hospital?

Most children having an endoscopic strip craniectomy recover very quickly after surgery and will be ready to be discharged after one night in hospital. At home, simple pain relief such as paracetamol and ibuprofen is all that is required to keep your child comfortable after this surgery.

How long does endoscopic strip craniectomy take?

The operation itself usually takes less than hour, although with anaesthetic time, positioning the patient on the table and application of dressings the whole process can take up to 2 hours before we call you to see your baby in the recovery room.

What are the risks of endoscopic strip craniectomy?

Endoscopic strip craniectomy is a very safe procedure when performed by an experienced craniofacial team. You should always be made aware of the rare problems that can occur even in experienced hands. As your surgeons will be operating near the brain, there is a small risk of injury to the brain and the blood vessels in this area. Rarely, a transfusion may be needed. There have been deaths and brain injury reported with this technique, although these are extremely unusual (<1%). Other complications include CSF (Cerebro spinal fluid) leak, poor scarring, and some children have a residual deformity that can be changed by further surgery.

What happens after this surgery?

After the surgery, you will be seen by your craniofacial surgeons. Your baby will have a bandage on their head to protect the wound and they will be transferred to the ward.

Patients tend to recover rapidly after this type of craniofacial surgery

You should arrange to meet the helmet company about a week after surgery when the swelling has subsided, and normally the custom made helmet will be ready in another week (2 weeks following surgery. In the first few weeks and months after surgery, you will need to visit the helmet team regularly to monitor the fit of the helmet. Adjustments to the helmet will be made at intervals as the shape of the head starts to improve over the course of treatment. The helmet needs to be worn at all times (except for when bathing) and treatment continues to around 18 months of age.

For more advice on endoscopic strip craniectomy, call 020 7927 6528 to arrange a consultation with Mr Juling Ong.