Sagittal Synostosis
Also known as scaphocephaly
Sagittal synostosis is the most common form of synostosis accounting for about 50% of all cases with a prevalence of 1 in 2000 live births. Premature fusion of the sagittal suture restricts the transverse growth of the skull. This results in an increased anteroposterior skull length to accommodate the growing brain. Frontal bossing and an exaggerated occiput can be pronounced and results in the classic “boat skull” appearance.
There are two common surgeries used to treat sagittal synostosis. One type is called a “strip” craniectomy, which is either done through a full-open or smaller-incision approach. Cuts are made along the fused sagittal suture and sometimes additional cuts are made laterally into both parietal This method requires a period of therapeutic helmet molding after surgery for an average of 12-18 months. This helmet is not covered by insurance. This procedure can only be performed successfully when the patient is younger, typically at 3 months of age.
The second type of surgery is a subtotal cranial reconstruction to recontour the posterior two thirds of the skull. The forehead is typically left to recontour on its own No helmet is required for this surgery. This procedure is done between 3-9 months.