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Cited by 106Craniofacial Disorders and TreatmentsPectus Deformity Diagnosis and TreatmentReconstructive Facial Surgery Techniques

Endoscopic versus open approach in craniosynostosis repair: a systematic review and meta-analysis of perioperative outcomes

Goyal, Anshit, Lu, Victor M., Yolcu, Yagiz U., Elminawy, Mohamed, Daniels, David J.·2018·Child's Nervous System
DOI 10.1007/s00381-018-3852-4
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Abstract

Introduction Surgery for craniosynostosis remains a crucial element in successful management. Intervention by both endoscopic and open approaches has been proven effective. Given the differences in timing and indications for these procedures, differences in perioperative outcomes have yet to be thoroughly compared between the two approaches. The aim of the systematic review and meta-analysis was to assess the available evidence of perioperative outcomes between the two approaches in order to better influence the management paradigm of craniosynostosis.Methods We followed recommended PRISMA guidelines for systematic reviews. Seven electronic databases were searched to identify all potentially relevant studies published from inception to February 2018 which were then screened against a set of selection criteria. Data were extracted and analyzed using meta-analysis of proportions.Results Twelve studies satisfied all the selection criteria to be included, which described a pooled cohort involving 2064 craniosynostosis patients, with 965 (47%) and 1099 (53%) patients undergoing surgery by endoscopic and open approaches respectively. When compared to the open approach, it was found that the endoscopic approach conferred statistically significant reductions in blood loss (MD = 162.4 mL), operative time (MD = 112.38 min), length of stay (MD = 2.56 days), and rates of perioperative complications (OR = 0.58), reoperation (OR = 0.37) and transfusion (OR = 0.09), where all p < 0.001.Conclusion Both endoscopic and open approaches for the surgical management of craniosynostosis are viable considerations. The endoscopic approach confers a significant reduction in operative and postoperative morbidity when compared to the open approach. Given that specific indications for either approach should be considered when managing a patient, the difference in perioperative outcomes remain an important element of this paradigm. Future studies will validate the findings of this study and consider long-term outcomes, which will all contribute to rigor of craniosynostosis management.

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  1. Lannelongue M (1890) De La Craniectomie Dans La Microcephalie. CR Seances Acad Sci 110:1382

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Authors
Goyal, A., Lu, V. M., Yolcu, Y. U., Elminawy, M., & Daniels, D. J.
Affiliations
Mayo Clinic (US)
Corresponding author
Daniels, David J.
ORCID
Venue
Child's Nervous System
Publisher
Springer Science and Business Media LLC
Published
2018-06-30
Volume
34
Issue
9
Pages
1627-1637
ISSN
  • 0256-7040 (ISSN-L)
  • 1433-0350
DOI
10.1007/s00381-018-3852-4
OpenAlex
W2810060657
Cited by
106
References
32
Citations by year
2026: 18 · 2025: 18 · 2024: 19 · 2023: 16 · 2022: 16 · 2021: 5 · 2020: 9 · 2019: 5
FWCI
0.67
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Child s Nervous System (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Craniofacial Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
Keywords
craniosynostosis, perioperative outcomes, operative time, blood loss, length of hospital stay, postoperative complications, reoperation, blood transfusion
MeSH terms
Craniosynostoses, Craniotomy, Humans, Prospective Studies, Retrospective Studies, Treatment Outcome, Minimally Invasive Surgical Procedures, Plastic Surgery Procedures, Neuroendoscopy, Observational Studies as Topic

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