Non-syndromic craniosynostoses – only an aesthetical problem?

Introduction: Because of an only aesthetical problem in children with non-syndromic craniosynostoses the discussion about the necessarity of surgical intervention has not been finished till today. Therefore 116 children were retrospectively evaluated considering clinical disturbances.

Methods: During June 1996 and December 2004 116 children with non-syndromic craniosynostoses were treated at the clinic Sud of Nurenberg. The children were examined by neuropediatrics, ophthalmologists, radiologists, craniomaxillofacial surgeons and at least the neurosurgeons. Postoperatively the same procedures were performed. Only the ophthalmological examination were reserved to these children who suffered from ophthalmological symptoms preoperatively and/or postoperatively. A x-ray of the skull was performed immediately after surgery and a computed tomography with 3-D-reconstructions 1–2 years postoperatively. The clinical follow up finished with 6 years or with start of school.

Results: Altogether 5 children have been operated upon due to clinical symptoms. Postoperatively all symptoms abolished or improved dramatically. The cephalic index increased in all children with a synostosis of the sagittal suture postoperatively. The postoperative calculated volume of the anterior fossa also increased in all children suffering from a premature synostoses of the metopica or coronar sutures.

Conclusions: Non-syndromic craniosynostoses seem to cause rarely early symptoms. However, even the cranial vault was operatively widened the clinical symptoms recovered slowly.