St. Luke's Hospital
Located in Chesterfield, MO
Main Number: 314-434-1500
Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia


    Craniosynostosis repair

    Craniectomy - child; Synostectomy; Strip craniectomy; Endoscopy-assisted craniectomy; Sagittal craniectomy; Frontal-orbital advancement; FOA

    Craniosynostosis repair is surgery to correct a problem that causes the bones of a child's skull to grow together (fuse) too early.


    This surgery is done in the operating room under general anesthesia. This means your child will be asleep and will not feel pain.

    Traditional surgery is called open repair. It includes these steps:

    • The most common place for a surgical cut to be made is over the top of the head, from just above one ear to just above the other ear. The cut is usually wavy. Where the cut is made depends on the specific problem.
    • A flap of skin, tissue, and muscle below the skin, and the tissue covering the bone are loosened and raised up so the surgeon can see the bone.
    • A strip of bone is usually removed where two sutures connect. This is called a strip craniectomy. Sometimes, larger pieces of bone must also be removed. This is called synostectomy. Parts of these bones may be changed or reshaped when they are removed. Then, they are put back. Other times, they are not.
    • Sometimes, bones that are left in place need to be shifted or moved.
    • Sometimes, the bones around the eyes are cut and reshaped.
    • Bones are fastened using a plate with screws that go into the skull. More and more surgeons are using resorbable plates and screws. The plates may expand as the skull grows.

    Surgery usually takes 3 to 7 hours. Your child will probably need to have a blood transfusion during or after surgery to replace blood that is lost during the surgery.

    A newer kind of surgery is used for some children. This type is usually done for children younger than 3 to 6 months old.

    • The surgeon makes one or two small cuts in the scalp. Most times these cuts are each just 1 inch long. These cuts are made above the area where the bone needs to be removed.
    • A tube that allows the doctor to see in (endoscope) is passed through the small cuts. Special medical devices and a camera are passed through the endoscope. Using these devices, the surgeon removes some bone through the cuts.
    • This surgery usually takes about 1 hour. There is much less blood loss with this kind of surgery.
    • Most children need to wear a special helmet to protect their head for a period of time after surgery.

    Children do best when they have this surgery when they are 3 months old. The surgery should be done before the child is 6 months old

    Why the Procedure Is Performed

    A baby's head, or skull, is made up of many different bones. The connections between these bones are called sutures. When a baby is born, it is normal for these sutures to be open a little. This gives the baby's brain room to grow.

    Craniosynostosis is a condition that causes one or more of the baby's sutures to close too early. This can cause the shape of your baby's head to be different than normal.

    An x-ray or computed tomography (CT) scan can be used to diagnose craniosynostosis. Surgery is usually needed to correct it.

    Surgery frees the sutures that are fused. It also reshapes the brow, eye sockets, and skull as needed. The goals of surgery are:

    • To relieve pressure on thechild's brain
    • To make sure there is enough room in the skull to allow the brain to properly grow
    • To improve the appearance of the child's head


    Risks for any surgery are:

    • Breathing problems
    • Infection, including in the lungs and urinary tract
    • Blood loss (children having an open repair may need a transfusion)
    • Reactions to medicines

    Possible risks of having this surgery are:

    • Infection in the brain
    • Bones connect together again, and more surgery is needed
    • Brain swelling
    • Damage to brain tissue

    Before the Procedure

    If the surgery is planned, you will need to take the following steps:

    During the days before the surgery:

    • Tell your doctor or nurse what drugs, vitamins, or herbs you are giving your child. This includes anything you bought without a prescription. You may be asked to stop giving your child some of these medicines in the days before the surgery.
    • Askthe doctor which medicines your child should still take on the day of the surgery.

    On the day of the surgery:

    • Give your child a small sip of water with any medicines your doctor told you to give your child.
    • Your child's doctor or nurse will tell you when to arrive for the surgery.

    Ask your doctor or nurse if your child can eat or drinkbefore surgery. In general:

    • Older children should not eat any food or drink any milk after midnight before the operation. They can have clear juice, water, and breast milk up to 4 hours before surgery.
    • Infants younger than 12 months can usually eat formula, cereal, or baby food until about 6 hours before surgery. They may have clear fluids and breast milk until 4 hours before surgery.

    Your doctor may ask you to wash your child with a special soap on the morning of the surgery. Rinse your child well.

    After the Procedure

    After surgery, your child will be taken to an intensive care unit (ICU). Your child will be moved to a regular hospital room after a day or two. Your child will stay in the hospital for 3 to 7 days.

    • Your child will have a large bandage wrapped around the head. There will also be a tube going into a vein. This is called an IV.
    • The nurses will watch your child closely.
    • Tests will be done to see if your child lost too much blood during surgery. A blood transfusion will be given, if needed.
    • Your child will have swelling and bruising around the eyes and face. Sometimes, the eyes may be swollen shut. This often gets worse in the first 3 days after surgery. It should be better by day 7.
    • Your child should stay in bed for the first few days. The headof your child's bed will beraised. This helps keep the swelling down.

    Talking, singing, playing music, and telling stories may help soothe your child. Acetaminophen (Tylenol) is used for pain. Your doctor can prescribeother pain medicines if your child needs them.

    Most children who have endoscopic surgery can go home after staying in the hospital 1 night.

    Outlook (Prognosis)

    Most of the time, the outcome from craniosynostosis repair is good.


    Kanev PM. Congenital malformations of the skull and meninges. Otolaryngol Clin North Am. 2007 Feb;40(1):9-26, v.

    Baskin JZ. Craniofacial surgery for congenital and acquired deforminities. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 185.

    Fairley JD,Sackerer D,Zeilhofer H,Sturtz G.Preliminary Experience With a Dynamic Resorbable Fixation Device for Craniosynostosis Surgery.Journal of Craniofacial Surgery, March 2012; Vol. 23 (2): ppe98–e100.


          Self Care

            Tests for Craniosynostosis repair

              Review Date: 11/2/2012

              Reviewed By: Luc Jasmin, MD, PhD, Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles and Department of Anatomy, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network.Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

              A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.

              Back  |  Top
              About Us
              Contact Us
              Locations & Directions
              Quality Reports
              Annual Reports
              Honors & Awards
              Community Health Needs

              Brain & Spine
              Sleep Medicine
              Urgent Care
              Women's Services
              All Services
              Patients & Visitors
              Locations & Directions
              Find a Physician
              Tour St. Luke's
              Patient & Visitor Information
              Contact Us
              Payment Options
              Financial Assistance
              Send a Card
              Mammogram Appointments
              Health Tools
              My Personal Health
              Spirit of Women
              Health Information & Tools
              Clinical Trials
              Employer Programs -
              Passport to Wellness

              Classes & Events
              Classes & Events
              Spirit of Women
              Donate & Volunteer
              Giving Opportunities
              Physicians & Employees
              For Physicians
              Remote Access
              Medical Residency Information
              Pharmacy Residency Information
              Physician CPOE Training
              St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
              Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Notice of Privacy Practices PDF  |  Patient Rights PDF Sitemap St. Luke's Mobile