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Surgical Options for Craniosynostosis

To treat craniosynostosis, we often recommend surgery. The age of your child, the presence of other medical conditions, and caretaker preference are factors that will determine which surgical treatment is the best route.

There are two common types of surgery for craniosynostosis:

  • Traditional surgery, also called calvarial vault remodeling
  • Minimally invasive endoscopic surgery

Traditional Surgery (“Calvarial Vault Remodeling”)

Among the surgical options available, the more traditional surgery we offer is when the baby is older. During surgery, an incision is made in the infant’s scalp. The shape of the head is corrected by moving the area that is abnormally fused or prematurely fused and then reshaping the skull so it can take more of a round contour. Surgery can last up to eight hours. The baby will likely spend one night in the ICU plus an additional 3-5 days in the hospital for monitoring.

Although the child’s deformity is seen early on, this surgery is ideal for babies beyond 6 months of age, because of expected blood loss. There is the possibility that a blood transfusion will be necessary during surgery. Learn more about donating blood for surgery.

After surgery, there may be temporary facial swelling. Unlike other surgical options, there are no additional steps post-surgery unless a recurrence of craniosynostosis is found. You can expect to follow up with your neurosurgeon at Johns Hopkins within one month post-surgery to check on the surgery incision site. Additional follow-up visits may occur at 6 and 12 months post-surgery.


Endoscopic Surgery (Minimally Invasive Surgery)

Dr Ahn with a babyPediatric neurosurgeon, Edward Ahn, with a patient and his mother.

This minimally invasive surgery is one that we perform when the baby is much younger (less than 3 months old).

The minimally invasive surgery involves the use of an endoscope. The endoscope is a small tube which the surgeon can look through and see immediately inside and outside the skull through very small incisions in the scalp. The surgeon opens the suture to enable the baby’s brain to grow normally.

The surgery itself takes approximately one hour and involves less blood loss compared to the calvarial vault remodeling; so there is little chance of requiring a blood transfusion. The babies usually stay in the hospital overnight and are then released to go home.

This type of surgery is followed by the use of a molding helmet. After the surgery is performed, we then prescribe the molding helmet. You can expect to follow up with your neurosurgeon every 3 months for the first year post-surgery to check progress of the helmet reshaping the skull. Additional appointments will be necessary with the helmet provider for fitting the helmet to your child.


For questions or to make an appointment, contact us at 410-502-7700.

Before you call, please contact your health insurance provider to ensure it participates with Johns Hopkins Hospital.

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