Inside Pediatrics Winter 2021

which the skull can form new bone to fill in surgically created soft spots. By “stretching” the bones of the skull more slowly, he said, the child’s body adjusts by making bone to fill in the growing gap. Regardless of the procedure used, early referrals are critical for these babies, said Dr. Rozzelle. “If we can see them by two months of age, that gives us plenty of time to get whatever preoperative assessments we need and get them on the schedule so that either the spring or endoscopic craniectomy with subsequent molding helmet is a viable option,” he said. Older babies cannot be treated endoscopically and require standard open surgery, which may lead to more blood loss and longer hospital stays.² Yet the craniofacial clinic still sometimes sees babies six months or older who never received a diagnosis or whose pediatrician didn’t refer them to Children’s. “That’s frustrating,” Dr. Rozzelle said. Nonetheless, said Dr. Myers, “Since we are comfortable with all of the techniques, we can tailor a plan to the individual child. No one is exactly the same.” For more information, visit childrensal.org/cleft-and-craniofacial-center. ¹ Arko L, Swanson JW, Fierst TM, et al. Spring-mediated sagittal craniosynostosis treatment at the Children’s Hospital of Philadelphia: technical notes and literature review. Neurosurg Focus. 2015 May;38(5):E7 ² Hashim PW, Patel A, Yang JF, et al. The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis. Plast Reconstr Surg 134:491–501, 2014.

Left to right, Rene Myers, M.D., John Grant, M.D. and James Johnston, M.D., work with patients and families at the Cleft and Craniofacial Center at Children’s of Alabama.

Left to right, Dr. Johnston and Dr. Myers review a patient who has had spring-mediated sagittal craniosynostosis treatment.

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