Protocol for Single Suture Craniosynostosis


Craniosynostosis, or fusion or one or more of the cranial sutures occurs in approximately 1 in 5,000 births. The majority of these involve only a single suture and there is no genetic cause able to be identified. The most common form of single suture craniosynostosis is sagittal synostosis. Metopic suture synostosis is the next most common, followed by fusion of one of the coronal sutures, or unicoronal synostosis. Lambdoid suture synostosis is very rare, however a small number of cases do present with this.

Patients are often referred to us soon after birth, and are managed by the Australian Craniofacial unit through to skeletal maturity. The protocol for management is outlined as follows:

Birth to three months of age

  • Craniofacial surgeon - Initial  consultation regarding management
  • Neurosurgery - Initial consultation regarding management
  • Ophthalmology -  Initial ophthalmological examination
  • ENT Surgeon - Check ears
  • Paediatrician - General medical review and developmental assessment
  • Craniofacial Registrar/Fellow - Take relevant medical history details
  • Social Worker - Introductory appointment, support for parents
  • Photography - Initial photographic documentation
  • Radiology Skull x-rays and 3D CT scan to confirm diagnosis and help plan surgical treatment

Three to six months of age

Preoperative appointments

  • Anaesthetist  
  • Visual Evoked Potentials 
  • Planning Meeting
    • Craniofacial Surgeons
    • Neurosurgeons

Surgery

  • Combined case with craniofacial and neurosurgical team

Postoperative reviews

  • 3D CT scan
  • Visual Evoked Potentials 
  • Fellow/Registrar
  • Craniofacial Surgeon
  • Neurosurgeon
  • Ophthalmologist

Six months to skeletal maturity

Patients are subsequently seen at 3 months post-surgery, then 6 months, and then annually thereafter until they have reached skeletal maturity. The annual appointments include:

  • Craniofacial Surgeon
  • Craniofacial Fellow/Registrar
  • Neurosurgeon
  • Photographs

 

Any other appointments are arranged on an as-needed basis.

As with any of our patients, if there are any concerns in between review appointments, parents are encouraged to contact the Australian Craniofacial Unit directly.