Craniosynostosis surgeries

Craniosynostosis – an early fusion of one of the cranial sutures (or several together) – is a phenomenon that occurs during infancy in one of every 2000 infants, but its causes are still unknown. The problem might cause serious deformity in the shape of the skull, and in severe situations even hurt the proper development of the brain.

The only treatment offered today for Craniosynostosis is surgery performed by a specialist neurosurgeon. At the Herzliya Medical Center private hospital neurosurgeons of the best in Israel, among them the greatest experts in Israel and the world in Craniosynostosis – professionals with many years of experience, who have performed dozens of successful operations like this so far.

Development of Craniosynostosis

The human skull is made of 26 different bones. Throughout the first 2 years of our lives, those bones remain flexible and dynamic and allow the gradual development of the brain, which grows rapidly during this period. In fact, the brain’s growth rate determines the growth rate of the skull, as well as its shape and appearance.

The ‘flexibility’ of the skull bones is enabled thanks to their natural division by sutures and fontanels. The sutures are the bones’ joints, and the fontanels are the sutures’ joints, which meet in 2 spots in the skull, anterior and posterior.

Throughout the 2 years during which the brain grows rapidly (from an average circumference of about 35 cm at birth to almost 50 cm at 1 year), the bone joins – the sutures – are made of soft tissue that ensures the skull’s flexibility. This tissue hardens gradually until it becomes an actual bone, part of the whole skull bone.

Craniosynostosis is an all-encompassing name for many phenomena related to the skull’s development that have one thing in common: early and quick fusion of one or more skull sutures, which directly hurts the proper development of the skull bone. Since the skull bones cannot develop properly where the suture has fused, they will ‘compensate’ for it through increased growth and development in a different spot, which leads to the distortion in the skull’s shape. This might be mostly a cosmetic and aesthetic problem, but in severe cases, this can even affect the development of the brain.

The causes of Craniosynostosis development

The reason for the development of the problem is still unknown. Sometimes, it is part of a chromosome problem known as the Apert syndrome, but in many cases, it occurs by itself, without an apparent reason and without any relation to this syndrome or another.

Moreover, we’ll note that Craniosynostosis is not hereditary: even if one of the parents or brothers suffers from the phenomena as an infant, the chances that another relative would have it is considered very low.

Diagnosis and treatment

Craniosynostosis will mostly be characterized, as mentioned, by an apparent distortion of the skull. The distortion is directly affected by the location of the fused suture, so in most cases, an external observation alone can indicate to the focus of the problem:

• A narrow and long skull indicated an early fusion of the sagittal suture (crossing the length of the skull)
• Asymmetrical skull, when comparing both sides, indicates a fusion of the coronal suture (lateral sutures)
• Short skull – flat in its anterior side and tends to grow high – indicates a fusion of the 2 coronal sutures
• ‘Triangle head’ indicates a fusion of the metopic suture (between the forehead bones).

The distortion can also be traced by measuring the circumference of the head and comparing it to the standard growth curves. This test would allow early detection of the problem even if the distortion is not yet apparent.

It should be noted that in rare cases, other symptoms would appear following the development of Craniosynostosis:

• Headaches
• Lack of appetite
• Vomiting
• Slower than usual development.

Either way, the final diagnosis will be made by the Herzliya Medical Center hospital staff, who has especially advanced imaging means. These means are considered the top of the imaging world, which guarantees an accurate diagnosis of the problem and all its features.

Treatment of Craniosynostosis will be mostly surgical. The surgery would be performed by a specialist pediatric neurosurgeon, accompanied by the regular staff that he has been cooperating with regularly for many years.

The recommendation is to have the surgery as early as possible, usually by 8 months old, because of the fact that at this stage, the joint bones of the skull sutures are still relatively soft, and also to prevent hurting the brain’s development. The surgery is between 2 and 6 hours long, depending on the problem, and is performed under general anesthesia.

There are a few types of surgeries for the treatment of Craniosynostosis, which vary based on the location of the fused suture and the number of sutures fused at the same time. In all surgeries, the surgeon would only treat the skull, without involved the brain tissues in the procedure, while installing plates or soluble sutures in the treated area, to guarantee its stability.

These are the main types of surgeries for treatment of Craniosynostosis:

• Surgery to repair the metopic suture (Forehead) will usually be performed for cosmetic purposes only, during which the surgeon would “rearrange” the shape of the skull after opening the fused suture. This surgery would usually be performed by the age of 6 months
• Surgery to repair the coronal sutures (lateral) performed in a similar way and time. This surgery could include repair of both coronal sutures together. This is one of the only conditions that are considered dangerous for the brain’s development
• Surgery to repair the sagittal suture (the suture in the middle of the skull) would usually require only an expansion of the suture. This surgery would mostly be performed very early, by the age of 3.5 months
• Surgery to repair the lambdoidal suture (posterior): mostly performed by 8 months, and considered to be mostly cosmetic as well. It should be noted that distortion in the backside of the skull occurs in many cases not due to Craniosynostosis, so the body “repairs” it naturally with time, without the need of surgery
• Surgery to treat the fusion of several sutures together: this condition could cause cranial pressure and significant damage to the development of the brain and its proper function. That’s why it is considered urgent and is performed in a relatively wide age range.

How to prepare the child for Craniosynostosis surgery?

The main objective is to create a familiar and relaxing environment as possible for your child. It’s recommended to bring toys he likes and even clothes he’s used to wearing. The meeting with the medical staff and the anesthesiologist prior to the actual surgery would also help this, and reduce the natural sense of foreignness and novelty.

Your child will have to fast completely for 4 to 6 hours prior to the surgery. Throughout the process, starting with your admission to the hospital through the surgery and the recovery of the child and up to the follow-ups he will undergo later, the hospital’s medical staff will be at your service, answer any questions and would be happy to assist you with anything.

The advantages of the Herzliya medical center hospital in Craniosynostosis surgeries

Craniosynostosis surgeries at the Herzliya medical center hospital are performed by the top doctors in the field, who would give your child the best professional treatment. In addition, you could set the date and time of the surgery yourselves, when it is convenient to you.

The hospital staff is skilled and caring and will be at your service at any time. Every patient and his family will have a nurse assigned to them for the entire hospitalization at the hospital, who would provide an immediate and quick response to any issue.

Adherence to the highest sanitary conditions, maintaining a clean and hygienic work environment, using the most advanced equipment (including the finest sanitation devices in the world) and of course the entire medical staff’s professionalism is guaranteed to reduce the risk of infection at the Herzliya medical center hospital to the lowest possible. This way, we can make sure that you and your family are not exposed to serious risks throughout the hospitalization period.

The hospital offers you great hosting conditions, a pleasant and calm environment, and especially advanced medical equipment. Great resources have been invested recently in building the excellence center for neurosurgery in the hospital, in order to give the doctor the most sophisticated equipment in the world and to create the perfect work environment for them.  The sophisticated equipment ensures maximal accuracy in any medical procedure and the particularly high rates of success that characterize the finest hospitals in the world. Thanks to the quality of the medical equipment and the high capabilities of the medical staff at the Herzliya medical center hospital, we can offer you the most precise, efficient and best treatment possible.

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