What is an endoscopic strip craniectomy?
Endoscopic strip craniectomy is a minimally invasive procedure to treat craniosynostosis, a condition where the sutures in the skull fuse too early during an infant’s development. Endoscopic strip craniectomy, also called endoscopic release surgery, works to release the fused sutures, helping restore the shape of your baby’s head and face, and giving their brain enough room to grow safely.
The Craniofacial Program team at Boston Children’s Hospital includes experts in endoscopic strip craniectomy and other minimally invasive approaches to treating craniosynostosis in infants and children.
What conditions does endoscopic strip craniectomy treat?
An endoscopic strip craniectomy is most often performed on babies between four to six months who have one or more fused sutures or craniosynostosis associated with a genetic condition such as:
What happens during endoscopic strip craniectomy?
Before endoscopic release surgery
Before endoscopic release surgery, a member of our craniofacial team (a neurosurgeon and possibly a plastic surgeon) will examine your baby. They may order x-rays or CT scans to find out more about your child’s condition than they can see in a physical exam.
Day of endoscopic release surgery
You and your child should arrive about two hours before their scheduled surgery time.
The endoscopic release surgery takes about two hours of total time in the operating room, during which the neurosurgeon will:
- Make one or two small incisions on your baby’s scalp, then small holes in the skull to start separating the bone.
- Use a thin, flexible tube called an endoscope to separate the layers of the scalp and the coverings of the brain (called dura) from the bone and remove the fused suture.
- Close the incisions with stitches. Stitches usually dissolve and fall out in about two to three weeks.
Most children who undergo endoscopic strip release surgery recover quickly and are discharged after one night in the hospital.
What is helmet therapy?
After surgery, an orthotist at Boston Children’s or a facility closer to your home will fit your baby with a custom-made helmet that they’ll wear for six to nine months to reshape their skull and allow for normal brain growth. At first, your baby will wear the helmet 23 hours a day, but the hours per day often decrease over time.
What happens after endoscopic release surgery?
Your child will be followed by members of the Craniofacial Program team for up to five or six years following endoscopic release surgery, with visits every three months during the first year and then annually to assess how well the skull is reshaping and how well the brain is developing. As part of our extensive follow-up care, we may recommend consultations with other specialties, such as ophthalmology, genetics, neuropsychology, and others.
Most children who undergo endoscopic strip craniectomy won’t have restrictions after surgery and recovery, and they won’t need further surgery. However, if your child has a known genetic syndrome contributing to their craniosynostosis, it’s possible that the skull bones can fuse back together, so there’s an increased chance of additional surgeries in the first two to three years of life.
Endoscopic Strip Craniectomy | Programs & Services
Programs
Oral and Maxillofacial Surgery Program
Program
The Oral and Maxillofacial Surgery Program provides a full range of surgical services for your child — and compassionate support for you and your family.
Cleft and Craniofacial Center
Program
The Cleft and Craniofacial Center treats children with a variety of congenital and acquired deformities.
Craniofacial Program
Program
Our program has a skilled team of clinicians experienced in diagnosing and treating children with a wide variety of craniofacial conditions.
Departments
Plastic and Oral Surgery
Department
The Department of Plastic and Oral Surgery is one of the largest and most experienced pediatric plastic and oral surgery centers in the world, with 10 dedicated subspecialty programs.
Neurosurgery
Department
The Department of Neurosurgery serves children with disorders of the brain, spine, and nervous system.