Craniosynostosis Treatment in Detroit
Craniosynostosis is a birth defect in which the bones in a baby’s skull join or fuse together too early. You may be aware that babies are born without these bones being fused and that is why you can feel or may have noticed your child’s “soft spot” on their head. These bones fuse together gradually over time creating the structural integrity of the skull to protect the brain. In craniosynostosis one or more of these bones begin to fuse early resulting in a misshapen appearance of the skull. There are many types of craniosynostosis and they are defined by which bones or sutures fuse early.
What to expect during your office visit:
Skull x-rays are the first screening tool if craniosynostosis is suspected. Much like an x-ray can identify a fracture in a bone elsewhere in your body, it is a good screening tool to identify if bones of the skull have prematurely fused. If you or your Pediatrician suspect craniosynostosis and x-rays have been completed please bring both the radiology report and the imaging on a disc to your appointment. If x-rays have not been completed you will first meet with one of Neurosurgeons and measurements of the child’s head will be performed. Next, the x-rays will be obtained. Children generally tolerate this very well since nothing touches them and caregivers can stay in the room with their child, wearing protective gear, while the x-rays are obtained. Following the x-rays our Neurosurgeons will review the pictures and discuss ideal treatment options.
At Children’s Hospital we work very closely with our Plastic Surgeons on many of our craniosynostosis cases, and you may be scheduled for a follow visit with that specialist as well. We also offer minimally invasive or endoscopic repair that requires only two very small incisions within the hairline. This approach has resulted in shorter hospital stays, decreased surgical blood loss, and faster recoveries. If the x-rays do not show craniosynostosis but rather plagiocephaly, or a flattening of the skull bones, a custom helmet can be fitted that corrects the issue over time without doing surgery. It is important to come see one of our Neurosurgeons so that we help inform you on the best decisions for your child.
What to expect from surgery:
If your family, with the guidance of our Neurosurgical team, has decided that surgery is the best approach this is what to expect. Families will be given a date and time during their clinic appointment. It is standard that children do not have anything to eat past midnight on the day of surgery. We understand this is difficult for our very young patients and take special care to schedule those surgeries as early in the day as possible. It is important you bathe your child and wash their hair either the night before or the morning of surgery to help prevent post operative infections.
In the morning your surgeon will review everything discussed in the office and be sure to answer any questions caregivers or children have. The surgery generally requires 1-3 hours to complete and updates will be provided by our OR staff. Once the surgery is complete your Neurosurgeon will come and discuss it with you directly. Children will then be taken to the recovery area and you will be able to join them there. They will be monitored as the effects of anesthesia wear off. Once this has occurred they will be observed in the Pediatric Intensive care Unit overnight.
There will be some pain associated with surgery, however, we are proactive with pain management and strive to keep our young patients comfortable. You can expect a routine head CT after surgery to evaluate the skull shape. Labs are also sent after surgery which is a quick poke if it can not be obtained through an IV. Usually, babies will remain in the hospital until their pain has subsided and their appetite resumes, generally 3-5 days.
Size and location of the incision will vary and is unique to each case. To care for the incision wash daily with a mild soap and dry gently. The incision will have small clear sutures that will dissolve on there own in approximately 10 days. Patients should avoid submerging the incision completely underwater for 14 days following surgery, so this means taking modified baths and no swimming in pools or lakes.
Caregivers and patients should monitor for any redness or swelling that occurs in the days or weeks following surgery. Rarely a superficial wound infection could occur and is easily treatable if detected early. Please notify the Neurosurgery department at (313)833-4490 of any redness, swelling, or drainage and one of Advance Practice Providers will provide you immediate guidance, and a same day appointment if necessary.
A scheduled “wound check” appointment will be made 10-14 days after surgery with one of our Advanced Practice Providers. This is a good time to talk about returning to school, day care, or other activities. This is another great opportunity to sit and answer any and all questions now that the stress of the hospital is behind you. In addition to the wound check, a scheduled follow up with your surgeon will be provided as well 4-6 weeks after surgery.