Early Outcomes of Endoscopic Spring-Assisted Repair of Metopic Craniosynostosis.

Introduction: Metopic craniosynostosis is often treated with endoscopic repair with helmeting in younger patients due to its safety profile. Spring-assisted open repair has shown utility in correcting hypotelorism in metopic craniosynostosis. This study presents the first report and early outcomes of endoscopic spring-assisted repair for metopic craniosynostosis.

Materials And Methods: A retrospective review was performed on all patients who underwent endoscopic spring-assisted repair of metopic craniosynostosis at a single tertiary children's hospital. Patient demographics, perioperative outcomes, and 3D photograms were obtained. Intercanthal distance, interfrontal angle, Head Shape Anomaly Index (HSA), and intracranial volume were calculated from the 3D photograms.

Results: Three patients underwent spring-assisted endoscopic strip craniectomy between 2.8 and 5.8 months old. The average procedure time was 114.7 minutes, with an average blood loss of 95 mL; 2 patients required a small transfusion (<25 mL/kg). All patients were discharged postoperative day 1. Postoperatively, intercanthal distance improved from below average to average or above average, and the average interfrontal angle improved from 116.32 to 126.56 degrees. The average HSA improved from 1.32 presurgically to 1.13 postsurgically. The average volume difference compared with each patient's normative reference volume increased from 5.39 to 7.23 mL.

Conclusions: This is the first report of early outcomes of spring-assisted endoscopic repair of metopic craniosynostosis. Perioperative safety outcomes were comparable to those in traditional endoscopic repair of metopic craniosynostosis. Morphologic outcomes were promising, as demonstrated by the improvement in intercanthal distance, interfrontal angle, and HSA. Future studies may compare the outcomes of this technique to those of traditional approaches.