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What To Expect During Craniosynostosis Surgery

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Before Surgery

Before your baby’s surgery, you’ll meet with a surgical team. This includes a pediatric neurosurgeon and a pediatric plastic surgeon. We will ask you about:

  • bleeding disorders in your family,
  • medications your baby is currently taking (if any), and 
  • allergies to food, medications, or latex your baby might have. 

Unless prescribed by your pediatrician, we will ask you not to give your baby aspirin, Motrin, Advil, or Ibuprofen five days before surgery. This helps prevent bleeding complications. You’ll bring your baby to the hospital the day before their scheduled surgery for blood tests. 

On the day of their procedure, your baby will be admitted to the hospital. An anesthesiologist will ask about your family’s history of reactions to general anesthesia. This information will help prevent possible reactions during your baby’s surgery.

Endoscopic-Assisted Craniectomy

This surgery is minimally invasive. A surgeon uses an endoscope to remove the fusion in your baby’s skull. An endoscope is a thin tube with a light and camera on the end of it. The surgery requires much smaller cuts in your baby’s head than the other types of surgery. 

This procedure takes about two hours. Babies who have endoscopic-assisted craniectomy surgery are not typically admitted to the intensive care unit (ICU) afterward. Most babies will spend one to two nights in the hospital. After the swelling from surgery goes down, they are fitted for a helmet and begin wearing it a couple of weeks after surgery. Typically, the helmet is worn for six months, but the duration varies from one child to another.

Cranial Vault Reconstruction

This procedure is done on babies age six months or older. It involves a larger incision (cut) that goes from ear to ear across the top of the baby’s head. A surgeon removes portions of the bone on the skull and then reconstructs the skull using plates and screws that dissolve.

Babies are usually in the hospital for four nights, with the first night spent in the ICU. This is major surgery and extra monitoring is needed to make sure they recover properly. They may stay in the ICU for more than one night if their condition during recovery requires more intensive care. 

Cranial Vault Distraction

This surgery is performed on older children, usually at least 1 year old. It involves an ear-to-ear incision, but no bone is removed. Instead, a surgeon cuts the bone and inserts distractors to make your baby’s skull bigger. 

Your baby will be admitted to the ICU for a recovery period afterward. This is major surgery, and extra monitoring is needed to ensure they recover properly. They will probably stay in the ICU for one night, or more if their condition requires additional intensive monitoring and care. After they are released from the ICU, they will usually stay in the hospital for three more nights before being discharged. Once their feeding and pain control routines have been established, they can be sent home. 

The distractors are placed on the skull. A small handle attached to each distractor sticks out through the skin. Your baby’s doctor will start turning the handles about three days after their surgery. When the handle is turned, the bones are slowly pushed apart a tiny amount. Your baby will not feel pain when this happens. 

You will turn the handles at home every night to slowly increase the distance (about a millimeter each day) between the bones. The handles that stick out through the skin are removed in the clinic several weeks after surgery. A second surgery is required to remove the distractors, which are left in place for several months. 

What to Expect After Craniosynostosis Surgery

Your baby will be discharged from the hospital based on the following criteria:

  • incision from the surgery healing well,
  • normal body temperature,
  • showing signs of returning to normal temperament (not excessively crying), 
  • nursing or taking bottles as usual, and
  • establishing a pain control routine.

Your baby will go home with some swelling under the scalp and stitches that dissolve. Swelling will go down in about one week. 

Craniosynostosis Surgery Complications

At home, you’ll want to watch for complications, such as:

  • fever over 101° F,
  • vomiting,
  • irritability,
  • redness at the incision site, 
  • increased swelling, 
  • decreased alertness, and 
  • drainage from the incision.

Call your baby’s doctor right away if you notice any of these symptoms. Most babies resume their normal personality and feeding routine within a few days of returning home from the hospital. We will schedule follow-up appointments to monitor any unusual symptoms that may occur after their surgery. 

Craniosynostosis Surgery Scar

Scars from craniectomy surgery are located on top of your baby’s head and cover up easily with hair. Cranial vault distractions and reconstruction surgeries typically leave a larger scar that is more difficult to cover, especially in children with short hair.

Find a Pediatric Surgeon

Make an Appointment for Craniosynostosis Surgery

If your baby needs craniosynostosis surgery, their pediatrician can refer them to our surgery department. You can also call us without a referral at 801-662-5346 to make an appointment.

Craniosynostosis surgery is covered by most health insurance policies. Our team will help with insurance authorization, but it’s always good to plan ahead and contact your carrier before your baby’s surgery to confirm that the surgery and helmets (if needed) are covered by your policy. 

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