Retrospective study of nonsyndromic craniosynostosis treated over a 10-year period

Since the first operation for premature suture closure in North America in 1888, there have been some fundamental changes in the treatment of these su tures, the latest being the U.S. Food and Drug Administration's 1996 approv al of a bioabsorbable fixation device. This retrospective study documents o ur experience with procedures performed primarily by Bennie J. van R. Zeema n for isolated craniosynostosis over a 10-year period. It was an attempt to evaluate factors affecting outcome and to determine the safety of the tech niques used to correct these congenital defects. Diagnoses included plagioc ephaly (116) and sagittal (44), metopic (17), and bilateral coronal (12) sy nostosis. All patients underwent fronto-orbital advancement or calvarial va ult remodeling, or both. The average patient age at time of sagittal synost osis surgery was 13.4 months; unilateral coronal synostosis, 12.2 months; d eformational plagiocephaly, 9.8 months; metopic synostosis, 8.6 months; and bilateral coronal synostosis, 10.4 months. Perioperative complications wer e minimal, with one mortality. Postoperative complications included three e ases involving infect-ion. The problem of reoperation for the removal of wi res and plates remains the greatest postoperative complication. Because of poor patient compliance, no accurate postoperative followup has been record ed. On the basis of our experience, we wish to point out some problems inhe rent in this surgery and also the complications that can occur despite care ful coordinated planning and team effort.