- Cosmetic outcomes: Visible outcomes after nonsyndromic cranial vault repair are excellent. For patients with single suture nonsyndromic craniosynostosis who undergo open surgery at older than 6 months of age, the redo rate is low (35, 53).
- Neurocognition: Recent neurocognitive studies suggest the presence of developmental delays in children with isolated single suture fusions. Close follow up in the craniofacial clinic or with neurodevelopmental testing may be in order (36, 43,45).
- Craniocerebral disproportion: There are very rare instances of lack of skull growth after craniosynostosis. This is more common with antiquated rigid fixation and after repair of syndromic craniosynostosis. However, the head circumference should be measured at each visit to assure that head growth is adequate (38,42).
- Cranial indices: In a series of 50 patients, quality of surgical outcome and cranial indices were better with cranial vault reconstructions (34).
- Reoperation rate: 0-8% may require require reoperation (53).
- Patient underwent minimally invasive repair.
- Minimally invasive sagittal repair
- Hypotelorism: Hypotelorism usually improves (17).
- Reoperation: 9–20% require reoperation for increased ICP or bandeau regression (33, 53).
- Open repair of metopic craniosynostosis
- Minimally invasive repair of metopic craniosynostosis
Unilateral Coronal Synostosis
- Reoperation: 12% may require surgery for increased ICP or bandeau regression (53).
- Neurodevelopment: Developmental delays are more likely in children with syndromic craniosynostosis than those with single suture craniosynostosis. The delays seen in single suture synostosis are due to the underlying disorders and not the suture closure (48).
Outcome After Nonsurgical Treatments
- Untreated cases: If not treated initially, the patient must be monitored for signs of increased ICP and neurocognitive delays.
- Neurocognition: Recent neurocognitive studies suggest mild developmental delays in children with isolated single suture fusions. Close follow up in the craniofacial clinic or with neurodevelopmental testing may be in order (36, 43, 45). SPECT studies may indicate a decrease in perfusion to the area of brain under the fused suture (15, 39). Negative psychosocial issues may occur with progressive cranial or facial deformity (6).
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