Child with scaphocephaly referred to our hospital for craniosynostosis surgery

The patient is a 1-year old boy from Jaisalmer, Rajasthan with scaphocephaly. This is the simplest form of craniosynostosis. It involves fusion of the sagittal suture. His mother became very worried after observing an abnormal shape to his growing head. A consultation with a local neurosurgeon confirmed the diagnosis of scaphocephaly. This doctor referred them to our hospital for surgical management of the child.

Patient scheduled for surgery after obtaining parental consent for surgery

Dr SM Balaji, Craniosynostosis surgery specialist, examined the child along with his team of neurosurgeons. He ordered a 3D CT scan and other imaging studies. This confirmed the earlier diagnosis of scaphocephaly. He explained the effects and potential complications to the parents. There could include increased intracranial pressure, visual impairments, seizures and skull deformities. They were advised that these needed immediate treatment. The child’s parents were in complete agreement and consented to surgery.

Mock surgery performed on 3D stereolithographic model of the patient’s skull

A 3D stereolithographic model was first obtained of the patient’s skull. The anatomy of the patient’s skull was studied and a mock surgery performed on this model.

Craniosynostosis surgery performed with adequate relief provided for growing brain

The neurosurgical team was present and assisted throughout the entire operation. Under general anesthesia, a bicoronal flap was first raised and skin clips used to hold the flap. Markings were then made on the bone and a craniotome used to section the skull. The bone along the edges of the cut skull sections was removed. This would provide adequate relief for brain growth. Barrel stave cuts were then made on the bony sections to provide further relief. This would ensure development of the brain to its full size.

Vicryl sutures were then used to hold the various bony sections in their correct place. The bicoronal flap was then closed using surgical staples. Vital signs were closely monitored throughout the surgery and were normal.

Uneventful postsurgical course after craniosynostosis surgery on the child

The child’s postoperative course was uneventful. He was very active and playful the day after surgery. They were then discharged with instructions to present in 12 days for staple removal.

Normal parameters observed at the 12th day postsurgical appointment

At the 12th day recall appointment, the patient’s postsurgical healing was normal. The surgical staples were then removed and the patient discharged. The patient will be monitored at regular intervals to ensure normal growth of the brain.