SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2018
Endoscopic versus open approach in craniosynostosis repair: a systematic review and meta-analysis of perioperative outcomes.
Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Postoperative raised ICP after minimally invasive surgery for monosutural craniosynostosis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Pooled it
- Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years.Orphanet journal of rare diseases · 2025Pooled it
- Long-term outcomes after surgical correction of anterior plagiocephaly secondary to isolated frontosphenoidal synostosis: a systematic review and two illustrative cases.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Pooled it
- Efficacy and safety of sagittal synostosis surgery in older (> 12 months) patients: a systematic review and meta-analysis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Pooled it
- Non-syndromic craniosynostosis: contemporary concepts in biology, diagnosis, and distraction-based operative strategy.Archives of craniofacial surgery · 2026Article
- Advantages of the double-incision approach in endoscopic management of unicoronal synostosis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- Spring-mediated cranioplasty for scaphocephaly: techniques and outcomes.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Endoscope-assisted release for pancraniosynostosis with delayed single-suture refusion managed with endoscopic re-release in the same patient: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- What is the ideal age for surgery in single-suture craniosynostosis?Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- Long-term outcome in 415 operated cases with single suture scaphocephaly.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Minimally invasive craniectomy and postoperative cranial remolding orthotic treatment in infants with craniosynostosis: A multicenter prospective study.World neurosurgery: X · 2023Article
- The Need for Additional Surgery after Passive versus Active Approaches to Syndromic Craniosynostosis: A Meta-analysis.Plastic and reconstructive surgery. Global open · 2023Article
- Endoscopic treatment of sagittal suture synostosis - a critical analysis of current management strategies.Neurosurgical review · 2022Review
- Minimally invasive strip craniectomy for metopic craniosynostosis using a lighted retractor.Neurosurgical focus: Video · 2021Article
- Operative Time as the Predominant Risk Factor for Transfusion Requirements in Nonsyndromic Craniosynostosis Repair.Plastic and reconstructive surgery. Global open · 2020Article
- Early Outcomes of Endoscopic Spring-Assisted Repair of Metopic Craniosynostosis.The Journal of craniofacial surgeryArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSurgery 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.
methodsWe 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.
resultsTwelve 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.
conclusionBoth 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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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.