ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
Long-term outcome in 415 operated cases with single suture scaphocephaly.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Neuro-developmental outcome in sagittal synostosis; Analysis of 488 children in the context of the existing literature.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
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Abstract
purposeThere are multiple options available for the surgical management of non-syndromic scaphocephaly. The goals of surgery are to correct the cranial deformity in order to optimize overall cosmetic appearance and to prevent raised intracranial pressure (ICP). At Alder Hey Children's Hospital NHS Trust, we offer a range of surgical procedures for single-suture scaphocephaly (SSS) from endoscopic strip craniectomy (ESC) with helmet therapy, sagittal suturectomy, and barrel staving - known as passive vault remodeling (PassiveVR), to an active subtotal (SVR) or total vault remodeling (TVR).
methodsWe conducted a retrospective analysis of all operated scaphocephaly patients at Alder Hey. All consecutive patients from 2012 to 2023 were included. Syndromic or multisuture synostosis cases were excluded. Age, type of surgery, issues of ICP at diagnosis, cephalic index (CI) pre- and postoperative, type and indication for reoperation, and length of follow-up were gathered in the database.
resultsFour hundred fifteen patients were included; 200 underwent PassiveVR, 206 underwent SVR/TVR, 8 underwent ESC + helmet, and one was treated with springs. The median follow-up period was 46 months. Eighteen patients underwent treatment due to high ICP related to synostosis, with the median age at surgery being 54 months in this group. Reoperations for intracranial hypertension or persistent abnormal shape were done for 17 patients treated initially with PassiveVR (8.5%), for 4 patients initially treated with SVR/TVR (1.9%), and for 1 patient initially treated with ESC + helmet (12.5%). Postoperative CI was significantly higher than preoperative CI in all operated patients (paired t-testing, p < 0.01).
conclusionPassiveVR and SVR/TVR are the most common procedures in our centre to treat scaphocephaly, with PassiveVR being performed earlier in life. In less than 10% of PassiveVR cases, reoperation due to increased ICP or abnormal head shape is required, with the benefit of PassiveVR being less invasive than SVR/TVR. Our experience with ESC is limited at present, but preliminary findings from this study suggest the need for long-term follow-up in order to identify early evidence of raised ICP or persistent deformity in this patient subgroup.
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