Results of experience with endoscopic craniectomy for craniosynostosis treatment
Ricardo Gómez Espinosa MD, Jesús Gómez Plasencia y C. MD, MSc
Results of craniosynostosis treatment have been notoriously improved after the introduction of endoscopic craniectomy techniques, resulting in shorter hospital stay, diminished blood loss, less operative time with less exposition to anesthesia, all of which result in a reduced global risk for the patients and lesser economic burden.
The present report compares the results between the first endoscopic craniectomy for craniosynostosis, just after the author’s training in neuroendoscopy, and the last one, performed in his daily practice.
Results regarding hospital stay, surgical time and anesthesia time and blood transfusion of the first early endoscopic craniectomy performed by the autor just upon his return from training periods at two european neurosurgical centers of excellence were compared to those of the last one performed after his return to his daily practice; both patients presented with scaphocephaly and both underwent endoscopic midline craniectomy through incisions 2.5 cm in endoscopic craniectomy length, 1 cm posterior to coronal and 1 cm anterior to lambdoid sutures.
In both cases with identical pathologies there were no surgical or anesthetic complications. The first case had longer surgical and anesthetic times and required blood transfusion, and presented two 1 and 3 mm respectively, dural tears which were repaired without further complications. The second case did not require blood transfusion and did not have any dural tears.
Results confirm that endoscopic craniectomy is a safe technique for early correction of craniosynostosis; the difference found in surgical and anesthetic times as well as in the transfusion required can be interpreted as due to more experience with the procedure. As any surgical technique, endoscopic craniectomy must have a specific training to avoid serious complications.