Initial Management at Presentation
- Initial treatment dependent on age at presentation: If the child is younger than 5 months of age, a minimally invasive procedure is undertaken. Otherwise, an open procedure is offered to the family. Some institutions will not offer the minimally invasive option if they feel that deformity is severe or if the child is older than 3 months of age.
- Surgery time-dependent on age of patient: The time of open surgery varies with the suture involved and varies greatly among institutions. Patients with sagittal synostosis are operated on between 4 and 7 months of age. Patients with coronal, metopic and lambdoid synostosis are operated on between 6 months and 1 year of age.
- Immediate, 2 weeks after surgery: Check the wound.
- 2, 6, and 12 months after surgery: Check the wound and palpate bony defects.
- Yearly thereafter in the craniofacial center: Check for bony defects and have evaluation by craniofacial team to include speech, psychology, dentistry, and orthodontics.
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