Objective: Surgery is the cornerstone of craniosynostosis treatment. In this study, two widely accepted techniques are described: endoscope-assisted surgery (EAS) and open surgery (OS). The authors compared the perioperative and reconstructive outcomes of EAS and OS in children ≤ 6 months of age treated at the Napoleón Franco Pareja Children's Hospital (Cartagena, Colombia).
Methods: According to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement, patients with defined criteria who underwent surgery to correct craniosynostosis between June 1996 and June 2022 were retrospectively enrolled. Demographic data, perioperative outcomes, and follow-up were obtained from their medical records. Student t-tests were used for significance. Cronbach's α was used to assess agreement between estimated blood loss (EBL). Spearman's correlation coefficient and the coefficient of determination were used to establish associations between the results of interest, and the odds ratio was used to calculate the risk ratio of blood product transfusion.
Results: A total of 74 patients met the inclusion criteria; 24 (32.4%) belonged to the OS group and 50 (67.6%) to the EAS group. There was a high interobserver agreement quantifying the EBL. The EBL, transfusion of blood products, surgical time, and hospital stay were shorter in the EAS group. Surgical time was positively correlated with EBL. There were no differences between the two groups in the percentage of cranial index correction at 12 months of follow-up.
Conclusions: Surgical correction of craniosynostosis in children aged ≤ 6 months by EAS was associated with a significant decrease in EBL, transfusion requirements, surgical time, and hospital stay compared with OS. The results of cranial deformity correction in patients with scaphocephaly and acrocephaly were equivalent in both study groups.
Keywords: children; craniofacial; craniosynostosis; endoscope-assisted surgery; treatment.