When is craniofacial surgery necessary?
The surgery is necessary in an infant who has craniosynostosis when the bones of the skull fuse together, or a craniofacial syndrome which causes fusion of the bones of the head and also abnormalities of the skull and face.
What is the ideal age at which a child should have surgery for craniosynostosis?
Surgery should be done within the first two weeks of life on those infants born with multiple fused sutures involved. When any of the other sutures are involved, surgery is done prior to 3 months of age when a less invasive microscopic procedure can be employed. In older children, the standard approach is employed at 6 months of age. For fusion of the remaining sutures, surgery is done at six months.
Will one operation be sufficient for craniosynostosis?
Most children who have single suture involvement require only one surgical procedure. However, for those with multiple suture involvement and those with craniofacial abnormalities associated with the craniosynostosis, multiple procedures are necessary.
What are the risks to the child in this type of surgery?
For healthy children with no other major medical problems, the risks are minimal. The major concern during surgery is blood loss because an infant's blood volume is low and the loss of a small amount may require replacement.
Do infants suffer brain damage when nothing is done for a misshapen head?
In those who have craniosynostosis or a craniofacial syndrome, there is a small group of 7 to 14 percent who have increased intracranial pressure which may result in brain damage if not treated.
Do the deformities cause other problems with ears or eyes?
Children with craniosynostosis, craniofacial syndromes, and positional deformities may have problems with their eyes and ears. Those with craniosynostosis and positional deformities have trouble with vision as a result of an imbalance of their ocular muscles. Children with craniofacial syndromes have problems with their ears and eyes and often have a history of ear abnormalities in conjunction with the bulging of the eyes and corneal exposure problems.
Why are both a plastic surgeon and neurosurgeon involved in the child's care?
The plastic surgeon reconstructs the facial deformity and the neurosurgeon is primarily involved with the cranial deformity. The combined expertise of the plastic surgeon and neurosurgeon yields optimal results.
If one child in the family has a deformity of the head, will another have the same?
In infants with craniosynostosis and positional deformities, there is no evidence of genetic transmission. In infants who have abnormal head shape from craniofacial syndromes, there is a history of genetic transmission.
Is there any scarring from the surgery and will it be apparent later in life?
The only visible scar is the scar in the hairline, which is usually covered nicely as the hair grows and the child ages.
What kind of post-surgical care is needed?
As a parent, you will need to keep your child's suture line clean. This involves removing all crusts with peroxide and antibiotic ointment and shampooing the infant's hair with baby shampoo.
Children’s Memorial Hermann Hospital
Houston, Texas 77030
Phone: (713) 704-5437
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This information, although based on a thorough knowledge and careful review of current medical literature, is the opinion of doctors at The University of Texas Medical School and is presented to inform you about surgical conditions. It is not meant to contradict any information you may receive from your personal physician and should not be used to make decisions about surgical treatment. If you have any questions about the information above or your child's care, please contact our doctors.