The DOI matches its Crossref record; 33 of the 33 references it cites were found in a registry or an index.
Twenty-Year Outcome Experience With Open Craniosynostosis Repairs: An Analysis of Reoperation and Complication Rates
Abstract
BACKGROUND: Surgical intervention during infancy for both syndromic and nonsyndromic patients with craniosynostosis remains the criterion standard of treatment with the 2 main options being open vault remodeling versus minimally invasive surgery. Although open cranial vault remodeling was initially considered a high-risk procedure, many advances have improved its safety. Despite this, there is a paucity of literature on the long-term outcomes of contemporary open craniosynostosis repair. METHODS: A retrospective review of all patients who underwent primary open cranial vault repair for craniosynostosis by a single surgeon (J.A.A.) at New York-Presbyterian Hospital from 1995 to 2015 was performed. RESULTS: For primary open repair, 81 patients (46 males, 35 females) were analyzed, and affected sutures included unicoronal (28), bicoronal (7), metopic (24), sagittal (11), lambdoid (2), and multisuture (9). Fourteen patients (17.3%) were syndromic. Mean (SD) operative patient age was 13.81 (16.24) months: 34 (42%) were 0 to 6 months; 26 (32%), 7 to 12 months; and 21 (26%), 12 months of age or older. There were no intraoperative complications. Mean (SD) estimated blood loss for the plastic surgery portion of all cases was 74.53 (72.34) mL, and total estimated blood loss was 174.93 (182.23) mL. Mean (SD) hospital length of stay was 4.31 (1.59) days. One syndromic patient was readmitted for a wound infection (1.2%) that was successfully treated with antibiotics, and 2 syndromic patients (2.5%) had reoperation for fronto-orbital readvancement. CONCLUSIONS: This 20-year experience demonstrates the safety of modern open craniosynostosis repairs at a large academic medical center with low rates of mortality (0%), complications (1.2%), and reoperations (2.5%).
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Morrison et al. reported that traditional open vault repairs do not necessarily reduce complications or the need for additional surgeries.
“Morrison et al. focused on reoperation and complication rates, emphasising that despite the historical importance of open techniques like these, they do not necessarily reduce complications or the need for additional surgeries [42].”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [42]
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“6%.(16,17) In particular, the rate of wound infection in this study (4.”
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Kamel, G. N., Wong, A., Segal, R. M., Carbullido, M. K., Hornacek, M., Ewing, E., Lance, S. H., & Gosman, A. A. (2021) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000007831 · Cited by 14
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“CVR remains a complex surgical procedure with a risk of significant complications, including injury to the brain, airway issues, critical bleeding events, and even death.(3,4) While improvements in pediatric anesthesia and surgical technique have significantly reduced the incidence of severe complications, they have n…”
Rajkumar, S., Ikeda, D. S., Scanlon, M., Shields, M. M., Kestle, J. R. W., Plonsker, J. H., Brandel, M. G., Gonda, D. D., Levy, M. L., Lucas, D. J., et al. (2023) · Child s Nervous System · doi:10.1007/s00381-023-06076-y · Cited by 10
“Although advancements in pediatric anesthetic care and surgical techniques have reduced the incidence of severe complications [5], CVR remains associated with complications such as brain injury, airway problems, acute blood loss anemia, and potentially death [6, 7].”
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“The number of complications in craniosynostosis surgery has dramatically changed during the last decade since the operative methods have evolved [6, 16, 24].”
Outcomes of the early endoscopic-assisted suturectomy for treatment of multisuture craniosynostosis
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“It should be noted that the reoperation rate varies among centers, which some studies have credited to syndromic synostosis with reoperation rates of 2.5–33% in the former group and 0–6.7% in the latter [20–22].”
InfluentialPuthumana, J. S., Lopez, C. D., Lake, I. V., & Yang, R. (2022) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000008872 · Cited by 7
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“8,12,13,17 Diagnosis codes identi fi ed a range of intraoperative complications, including hemorrhage and hematomas and cardiac complications.”
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Anesthetics affect peripheral venous pressure waveforms and the cross-talk with arterial pressure
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“In a 20-year retrospective analysis of open cranial vault repairs, Morrison et al. focused on reoperation and complication rates, emphasising that despite the historical importance of open techniques like these, they do not necessarily reduce complications or the need for additional surgeries [42].”
Kim, D. K., Gu, K., & Ascherman, J. A. (2026) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000012726 · Cited by 1
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Open approaches to craniosynostosis repair: indications, techniques, outcomes, and future directions
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Cho, D., Birgfeld, C. B., Lee, A., Ellenbogen, R. G., & Susarla, S. M. (2020) · World Neurosurgery · doi:10.1016/j.wneu.2020.07.099
Epilepsy in Patients with Craniosynostosis: A Systematic Review
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Trends in Open Versus Minimally Invasive Craniosynostosis Repair: A 10-Year National Analysis
Fung, E., Yu, B. Z., Roth, J. M., Godek, M., Shih, S., Morgenstern, P. F., & Taub, P. J. (2025) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000011306
Craniosynostosis: Experience From a Single Tertiary Center in India
Singh, M., Nibber, M., Kaur, G., Raswan, U. S., Joseph, A., Zaita, B., Singh, J., Singh, A., Talwar, A., Kaur, H., et al. (2025) · Cureus · doi:10.7759/cureus.82179
“Morrison et al., in a pooled cohort of both children and adults, reported unicoronal suture as the most affected suture [17].”
Alhusainan, H., Alshaya, W. A., Qasim, S. S., Alyamani, A. M., Alhazmi, B. D., Ulhaq, M. M., AlBattal, N. Z., & Al-Tuwaijri, A. S. (2025) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000006905
“Morrison et al 21 presented a 20-year experience at a large academic medical facility and found a 0% death rate, 1.2% complication rate, and 2.5% reoperation rate for open craniosynostosis procedures.”
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Early Surgery: Endoscopic Strip Craniectomy (ESC)
Proctor, M. R., & Hartman, E. K. (2026) · Springer eBooks · doi:10.1007/978-3-032-12551-4_15
Spagnol, G., dos Santos, P. A. F., Nogueira, L. M., Coutinho, M. A., Grillo, R., & Lima, B. C. (2026) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2026.109923
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Metadata
- Authors
- Morrison, K. A., Lee, J. C., Souweidane, M. M., Feldstein, N. A., & Ascherman, J. A.
- Affiliations
- NewYork–Presbyterian Hospital (US)
- Corresponding author
- Morrison, Kerry A.
- Lee, James C.
- Ascherman, Jeffrey A.
- Venue
- Annals of Plastic Surgery
- Published
- 2018-04
- Volume
- 80
- Issue
- 4
- Pages
- S158-S163
- ISSN
- 0148-7043 (ISSN-L)
- OpenAlex
- W2791978195
- Cited by
- 35
- References
- 33
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 2 · 2023: 3 · 2022: 7 · 2021: 4 · 2020: 2 · 2019: 4
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Plastic Surgery (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, long-term surgical outcomes, syndromic craniosynostosis, nonsyndromic craniosynostosis, metopic craniosynostosis, unicoronal craniosynostosis, surgical complications, reoperation
- MeSH terms
- Craniosynostoses, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Male, Postoperative Complications, Reoperation, Retrospective Studies, Treatment Outcome, Orthopedic Procedures, Kaplan-Meier Estimate
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