Minimally Invasive Strip Craniectomy for Sagittal Synostosis
Abstract
The most common approaches used today for the correction of sagittal synostosis involve large craniectomies and extensive cranial vault remodeling. Although these techniques ultimately yield very good cosmetic results, they have significant drawbacks. They are lengthy, expensive, associated with significant blood loss, universally require transfusions, and often result in prolonged hospitalization.We present here our 5-year experience with correction of sagittal synostosis using the recently described minimally invasive strip craniectomy followed by postoperative cranial vault helmet molding. During this period, we treated a total of 97 children with nonsyndromic single-suture synostosis. The first 46 of 67 children treated for sagittal synostosis had at least 1 year of postoperative follow-up and were included in the analysis. There were 33 boys and 13 girls. Patients' mean age at surgery was 3.1 months, and the mean weight was 6.1 kg. The mean operative time was 75 minutes. The estimated blood loss during the procedure was 56 mL. Eight patients received blood transfusions during surgery (17.4%) and 3 patients received after surgery (6.5%). There were no significant postoperative complications. The mean hospitalization was 2.2 days. Excellent aesthetic outcomes were noted in all patients. The change in cranial index from a preoperative value of 0.7 to 0.8 postoperatively was virtually stabilized 3 months after the surgical intervention. Significantly better correction rates were observed in the youngest patients.Because of its excellent attributes, minimally invasive strip craniectomy followed by postoperative helmet molding is likely to become the preferred treatment modality for the correction of sagittal synostosis.
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Gociman et al. provided evidence for the efficacy of minimally invasive strip craniectomy for sagittal synostosis.
“Gociman et al. explored minimally invasive strip craniectomy for sagittal synostosis in a retrospective study, providing evidence for the technique's efficacy in treating this condition [56].”
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 [56]
Integration of helmet therapy after endoscopic procedures increased corrective effect, especially for sagittal craniosynostosis.
“The integration of helmet therapy after endoscopic procedures showed an increased corrective effect, especially for the sagittal Craniosynostosis [1, 53, 55, 56].”
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 [56]
Minimally invasive techniques such as ESC are efficacious, particularly in younger patients, and are viable alternatives in the surgical management of craniosynostosis.
“Additionally, Riordan et al. and Gociman et al. supported the efficacy of minimally invasive techniques such as ESC, particularly in younger patients, reinforcing their role as viable alternatives in the surgical management of craniosynostosis [55, 56].”
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 [56]
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- Authors
- Gociman, B., Marengo, J., Ying, J., Kestle, J. R. W., & Siddiqi, F.
- Affiliations
- University of Utah (US)
- Primary Children's Hospital (US)
- Corresponding author
- Gociman, Barbu
- Marengo, Jason
- Siddiqi, Faizi
- ORCID
- Kestle, John R.W.
- Venue
- Journal of Craniofacial Surgery
- Published
- 2012-05
- Volume
- 23
- Issue
- 3
- Pages
- 825-828
- ISSN
- 1049-2275 (ISSN-L)
- OpenAlex
- W2335479737
- Cited by
- 44
- References
- 9
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 9 · 2014: 3 · 2013: 1
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Craniofacial Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (C06RR011234, C06-RR-11234, UL1RR025764)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Keywords
- sagittal synostosis, strip craniectomy, cranial vault remodeling, nonsyndromic craniosynostosis, cranial index, blood loss, postoperative complications, cosmetic outcome
- MeSH terms
- Blood Transfusion, Craniosynostoses, Craniotomy, Esthetics, Female, Head Protective Devices, Humans, Infant, Length of Stay, Male, Retrospective Studies, Blood Loss, Surgical, Treatment Outcome, Minimally Invasive Surgical Procedures, Plastic Surgery Procedures
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