New procedure to help children with abnormal skulls

Much less invasive than traditional treatment

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JACKSONVILLE, Fla. - There is a new procedure in Jacksonville that helps children born with craniosynostosis; a condition where the skull is not fully formed in newborns. It's done by University of Florida & Shands doctors, who also work with Wolfsons Children's Hospital.

In appropriate cases the procedure is done through two small incisions and is much less invasive. Much of the procedure is done with an endoscope. The procedure is about 30-40 minutes, usually does not require transfusion (blood loss around 25cc). The baby stays in the hospital for 2 nights which may go down to one and has minimal swelling.

It must be done in children under 6 months of age and they must wear a reshaping helmet for 12 months after surgery. However, in the open technique requiring a scalp incision from ear to ear, taking the skull apart and reshaping it is the present alternative. This procedure takes 4-5 hours, requires blood transfusions, and a hospital stay of 5 days.

The treatment is new for Jacksonville but has been used with great success in San Antonio. It is used to treat children whose skull growth sites (sutures)fuse too early causing skull deformity and potentially increased intracranial pressures.

Here are some facts about Pediatric Craniosynostosis:

• Pediatric Craniosynostosis = Premature fusion of 1 or more cranial sutures (growth plates of the skull) resulting in abnormal head shape
• Prevalence of 0.1-0.15% in the general population
• 2-8% have primary synostosis
• Incidence of 1:3,000 live births in US
• 5-15% involve multiple sutures, usually syndromic
• Familial cases (5% of total) inherited in autosomal dominant pattern
• Male = Female (no gender predilection)
• Of primary craniosynostosis cases, sagittal is most common (56-58%), followed by coronal (14-55%), metopic (5-20%) and lambdoid (1-3%)
• Endoscopic-assisted craniectomy and helmeting
• Introduced by Drs. Jimenez and Barone, 1996
• Performed prior to 6 months of age
• 1 year of 23/7 helmet orthosis postoperatively
• Decreased blood loss, shorter operative time, reduced hospital LOS (decreased cost) compared to open approach
• Outcomes equivalent to open approach as measured by mean postoperative cephalic index

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