{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T06:06:23Z","timestamp":1775887583494,"version":"3.50.1"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Endoscope-assisted repair of sagittal craniosynostosis was adopted at St. Louis Children\u2019s Hospital in 2006. This study examines the first 100 cases and reviews the outcomes and evolution of patient care protocols at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors performed a retrospective chart review of the first 100 consecutive endoscopic repairs of sagittal craniosynostosis between 2006 and 2014. The data associated with length of hospital stay, blood loss, transfusion rates, operative times, cephalic indices (CIs), complications, and cranial remolding orthosis were reviewed. Measurements were taken from available preoperative and 1-year postoperative 3D reconstructed CT scans.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The patients\u2019 mean age at surgery was 3.3 \u00b1 1.1 months. Of the 100 patients, 30 were female and 70 were male. The following perioperative data were noted. The mean operative time (\u00b1 SD) was 77.1 \u00b1 22.2 minutes, the mean estimated blood loss was 34.0 \u00b1 34.8 ml, and the mean length of stay was 1.1 \u00b1 0.4 days; 9% of patients required transfusions; and the mean pre- and postoperative CI values were 69.1 \u00b1 3.8 and 77.7 \u00b1 4.2, respectively. Conversion to open technique was required in 1 case due to presence of a large emissary vein that was difficult to control endoscopically. The mean duration of helmet therapy was 8.0 \u00b1 2.9 months. Parietal osteotomies were eventually excluded from the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The clinical outcomes and improvements in CI seen in our population are similar to those seen at other high-volume centers. Since the inception of endoscope-assisted repair at our institution, the patient care protocol has undergone several significant changes. We have been able to remove less cranium using our \u201cnarrow-vertex\u201d suturectomy technique without affecting patient safety or outcome. Patient compliance with helmet therapy and collaborative care with the orthotists remain the most essential aspects of a successful outcome.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.5.peds16674","type":"journal-article","created":{"date-parts":[[2017,8,25]],"date-time":"2017-08-25T13:55:21Z","timestamp":1503669321000},"page":"410-418","source":"Crossref","is-referenced-by-count":45,"title":["One hundred consecutive endoscopic repairs of sagittal craniosynostosis: an evolution in care"],"prefix":"10.3171","volume":"20","author":[{"given":"Dennis C.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott J.","family":"Farber","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary B.","family":"Skolnick","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sybill D.","family":"Naidoo","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew D.","family":"Smyth","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex A.","family":"Kane","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamlesh B.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert S.","family":"Woo","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1097\/SCS.0b013e318240f965","article-title":"Cost of treating sagittal synostosis in the first year of life","volume":"23","author":"Abbott MM","year":"2012","unstructured":"Abbott MM, Rogers GF, Proctor MR, Busa K, Meara JG: Cost of treating sagittal synostosis in the first year of life. J Craniofac Surg 23:88\u201393, 201210.1097\/SCS.0b013e318240f96522337381"},{"issue":"2","key":"b2","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/2011.6.FOCUS1198","article-title":"Endoscope-assisted strip craniectomy and postoperative helmet therapy for treatment of craniosynostosis","volume":"31","author":"Berry-Candelario J","year":"2011","unstructured":"Berry-Candelario J, Ridgway EB, Grondin RT, Rogers GF, Proctor MR: Endoscope-assisted strip craniectomy and postoperative helmet therapy for treatment of craniosynostosis. Neurosurg Focus 31(2):E5, 201110.3171\/2011.6.FOCUS119821806344"},{"key":"b3","series-title":"Plast Reconstr Surg","first-page":"114e","article-title":"The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis","volume":"136","author":"Derderian CA","year":"2015","unstructured":"Derderian CA, Heppner C, Cradock MM, Woo AS, Patel KB, Smyth MD, : The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis. Plast Reconstr Surg 136:114e\u2013115e, 2015"},{"key":"b4","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"674","DOI":"10.3171\/2016.6.PEDS1623","article-title":"Endoscope-assisted management of sagittal synostosis: wide vertex suturectomy and barrel stave osteotomies versus narrow vertex suturectomy","volume":"18","author":"Dlouhy BJ","year":"2016","unstructured":"Dlouhy BJ, Nguyen DC, Patel KB, Hoben GM, Skolnic GB, Naidoo SD, : Endoscope-assisted management of sagittal synostosis: wide vertex suturectomy and barrel stave osteotomies versus narrow vertex suturectomy. J Neurosurg Pediatr 18:674\u2013678, 201610.3171\/2016.6.PEDS1623"},{"key":"b5","series-title":"Pediatr Crit Care Med","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1097\/PCC.0b013e3182192c7b","article-title":"Femoral artery catheterization in neonates and infants","volume":"13","author":"Dumond AA","year":"2012","unstructured":"Dumond AA, da Cruz E, Almodovar MC, Friesen RH: Femoral artery catheterization in neonates and infants. Pediatr Crit Care Med 13:39\u201341, 20122147878910.1097\/PCC.0b013e3182192c7b"},{"key":"b6","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1097\/PRS.0000000000001505","article-title":"Comparison of traditional versus normative cephalic index in patients with sagittal synostosis: measure of scaphocephaly and postoperative outcome","volume":"136","author":"Dvoracek LA","year":"2015","unstructured":"Dvoracek LA, Skolnick GB, Nguyen DC, Naidoo SD, Smyth MD, Woo AS, : Comparison of traditional versus normative cephalic index in patients with sagittal synostosis: measure of scaphocephaly and postoperative outcome. Plast Reconstr Surg 136:541\u2013548, 20152598930110.1097\/PRS.0000000000001505"},{"key":"b7","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"361","DOI":"10.3171\/2015.7.PEDS15187","article-title":"Characterization of complications associated with open and endoscopic craniosynostosis surgery at a single institution","volume":"17","author":"Han RH","year":"2016","unstructured":"Han RH, Nguyen DC, Bruck BS, Skolnick GB, Yarbrough CK, Naidoo SD, : Characterization of complications associated with open and endoscopic craniosynostosis surgery at a single institution. J Neurosurg Pediatr 17:361\u2013370, 201610.3171\/2015.7.PEDS15187"},{"key":"b8","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1097\/PRS.0000000000000420","article-title":"The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis","volume":"134","author":"Hashim PW","year":"2014","unstructured":"Hashim PW, Patel A, Yang JF, Travieso R, Terner J, Losee JE, : The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis. Plast Reconstr Surg 134:491\u2013501, 201410.1097\/PRS.000000000000042024804639"},{"key":"b9","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"77","DOI":"10.3171\/jns.1998.88.1.0077","article-title":"Endoscopic craniectomy for early surgical correction of sagittal craniosynostosis","volume":"88","author":"Jimenez DF","year":"1998","unstructured":"Jimenez DF, Barone CM: Endoscopic craniectomy for early surgical correction of sagittal craniosynostosis. J Neurosurg 88:77\u201381, 1998942007610.3171\/jns.1998.88.1.0077"},{"key":"b10","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1007\/s00381-012-1768-y","article-title":"Endoscopic technique for sagittal synostosis","volume":"28","author":"Jimenez DF","year":"2012","unstructured":"Jimenez DF, Barone CM: Endoscopic technique for sagittal synostosis. Childs Nerv Syst 28:1333\u20131339, 201210.1007\/s00381-012-1768-y22872245"},{"key":"b11","series-title":"Pediatrics","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1542\/peds.110.1.97","article-title":"Early management of craniosynostosis using endoscopic-assisted strip craniectomies and cranial orthotic molding therapy","volume":"110","author":"Jimenez DF","year":"2002","unstructured":"Jimenez DF, Barone CM, Cartwright CC, Baker L: Early management of craniosynostosis using endoscopic-assisted strip craniectomies and cranial orthotic molding therapy. Pediatrics 110:97\u2013104, 20021209395310.1542\/peds.110.1.97"},{"issue":"5 Suppl Pediatrics","key":"b12","series-title":"J Neurosurg","first-page":"407","article-title":"Endoscopy-assisted wide-vertex craniectomy, barrel stave osteotomies, and postoperative helmet molding therapy in the management of sagittal suture craniosynostosis","volume":"100","author":"Jimenez DF","year":"2004","unstructured":"Jimenez DF, Barone CM, McGee ME, Cartwright CC, Baker CL: Endoscopy-assisted wide-vertex craniectomy, barrel stave osteotomies, and postoperative helmet molding therapy in the management of sagittal suture craniosynostosis. J Neurosurg 100 (5 Suppl Pediatrics):407\u2013417, 200415287447"},{"key":"b13","series-title":"Nat Genet","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1038\/ng.2463","article-title":"A genome-wide association study identifies susceptibility loci for nonsyndromic sagittal craniosynostosis near BMP2 and within BBS9","volume":"44","author":"Justice CM","year":"2012","unstructured":"Justice CM, Yagnik G, Kim Y, Peter I, Jabs EW, Erazo M, : A genome-wide association study identifies susceptibility loci for nonsyndromic sagittal craniosynostosis near BMP2 and within BBS9. Nat Genet 44:1360\u20131364, 201210.1038\/ng.246323160099"},{"key":"b14","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1097\/00001665-199503000-00002","article-title":"Surgical correction of sagittal craniosynostosis: complications of the pi procedure","volume":"6","author":"Kanev PM","year":"1995","unstructured":"Kanev PM, Lo AK: Surgical correction of sagittal craniosynostosis: complications of the pi procedure. J Craniofac Surg 6:98\u2013102, 199510.1097\/00001665-199503000-000028601027"},{"key":"b15","series-title":"Plast Reconstr Surg","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1097\/PRS.0b013e31823aec1d","article-title":"Changes in frontal morphology after single-stage open posterior-middle vault expansion for sagittal craniosynostosis","volume":"129","author":"Khechoyan D","year":"2012","unstructured":"Khechoyan D, Schook C, Birgfeld CB, Khosla RK, Saltzman B, Teng CC, : Changes in frontal morphology after single-stage open posterior-middle vault expansion for sagittal craniosynostosis. Plast Reconstr Surg 129:504\u2013516, 201210.1097\/PRS.0b013e31823aec1d22286431"},{"key":"b16","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1001\/jama.1892.02411060019001f","article-title":"Pioneer craniectomy for relief of mental imbecility due to premature sutural closure and microcephalus","volume":"18","author":"Lane LC","year":"1892","unstructured":"Lane LC: Pioneer craniectomy for relief of mental imbecility due to premature sutural closure and microcephalus. JAMA 18:49\u201350, 189210.1001\/jama.1892.02411060019001f"},{"key":"b17","series-title":"Compt Rend Seances Acad Sci","first-page":"1382","article-title":"De la craniectomie dans la microcephalie","volume":"110","author":"Lannelongue M","year":"1890","unstructured":"Lannelongue M: De la craniectomie dans la microcephalie. Compt Rend Seances Acad Sci 110:1382\u20131385, 1890"},{"key":"b18","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1097\/SCS.0000000000000613","article-title":"Assessing long-term outcomes of open and endoscopic sagittal synostosis reconstruction using three-dimensional photography","volume":"25","author":"Le MB","year":"2014","unstructured":"Le MB, Patel K, Skolnick G, Naidoo S, Smyth M, Kane A, : Assessing long-term outcomes of open and endoscopic sagittal synostosis reconstruction using three-dimensional photography. J Craniofac Surg 25:573\u2013576, 201410.1097\/SCS.000000000000061324577302"},{"issue":"6","key":"b19","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/2010.9.FOCUS10204","article-title":"The evolution of surgical management for craniosynostosis","volume":"29","author":"Mehta VA","year":"2010","unstructured":"Mehta VA, Bettegowda C, Jallo GI, Ahn ES: The evolution of surgical management for craniosynostosis. Neurosurg Focus 29(6):E5, 201010.3171\/2010.9.FOCUS1020421121719"},{"key":"b20","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1097\/SCS.0000000000001321","article-title":"Are endoscopic and open treatments of metopic synostosis equivalent in treating trigonocephaly and hypotelorism?","volume":"26","author":"Nguyen DC","year":"2015","unstructured":"Nguyen DC, Patel KB, Skolnick GB, Naidoo SD, Huang AH, Smyth MD, : Are endoscopic and open treatments of metopic synostosis equivalent in treating trigonocephaly and hypotelorism? J Craniofac Surg 26:129\u2013134, 20152553405610.1097\/SCS.0000000000001321"},{"key":"b21","series-title":"J Craniofac Surg","first-page":"247","article-title":"Lack of ossification after cranioplasty for craniosynostosis: a review of relevant factors in 592 consecutive patients","volume":"4","author":"Prevot M","year":"1993","unstructured":"Prevot M, Renier D, Marchac D: Lack of ossification after cranioplasty for craniosynostosis: a review of relevant factors in 592 consecutive patients. J Craniofac Surg 4:247\u2013256, 19938110906"},{"key":"b22","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"620","DOI":"10.3171\/2011.3.PEDS10418","article-title":"The management of sagittal synostosis using endoscopic suturectomy and postoperative helmet therapy","volume":"7","author":"Ridgway EB","year":"2011","unstructured":"Ridgway EB, Berry-Candelario J, Grondin RT, Rogers GF, Proctor MR: The management of sagittal synostosis using endoscopic suturectomy and postoperative helmet therapy. J Neurosurg Pediatr 7:620\u2013626, 20112163119910.3171\/2011.3.PEDS10418"},{"key":"b23","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"617","DOI":"10.3171\/jns.1999.91.4.0617","article-title":"Intracranial volume change in craniosynostosis","volume":"91","author":"Sgouros S","year":"1999","unstructured":"Sgouros S, Hockley AD, Goldin JH, Wake MJ, Natarajan K: Intracranial volume change in craniosynostosis. J Neurosurg 91:617\u2013625, 19991050738410.3171\/jns.1999.91.4.0617"},{"key":"b24","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"165","DOI":"10.3171\/2011.5.PEDS1128","article-title":"Endoscopically assisted versus open repair of sagittal craniosynostosis: the St. Louis Children\u2019s Hospital experience","volume":"8","author":"Shah MN","year":"2011","unstructured":"Shah MN, Kane AA, Petersen JD, Woo AS, Naidoo SD, Smyth MD: Endoscopically assisted versus open repair of sagittal craniosynostosis: the St. Louis Children\u2019s Hospital experience. J Neurosurg Pediatr 8:165\u2013170, 201110.3171\/2011.5.PEDS1128"},{"key":"b25","series-title":"Plast Reconstr Surg","first-page":"646e","article-title":"The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis","volume":"135","author":"Speltz ML","year":"2015","unstructured":"Speltz ML, Birgfeld C, Starr JR, Collett B, Kapp-Simon K: The effects of whole-vault cranioplasty versus strip craniectomy on long-term neuropsychological outcomes in sagittal craniosynostosis. Plast Reconstr Surg 135:646e\u2013647e, 2015"},{"key":"b26","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"324","DOI":"10.3171\/2013.12.PEDS13320","article-title":"A comparison of costs associated with endoscope-assisted craniectomy versus open cranial vault repair for infants with sagittal synostosis","volume":"13","author":"Vogel TW","year":"2014","unstructured":"Vogel TW, Woo AS, Kane AA, Patel KB, Naidoo SD, Smyth MD: A comparison of costs associated with endoscope-assisted craniectomy versus open cranial vault repair for infants with sagittal synostosis. J Neurosurg Pediatr 13:324\u2013331, 201410.3171\/2013.12.PEDS1332024410127"},{"key":"b27","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1097\/SCS.0000000000001405","article-title":"Does perioperative steroid use improve clinical outcomes in open repair of craniosynostosis?","volume":"26","author":"Wei AT","year":"2015","unstructured":"Wei AT, Madsen C, Al-Sheemy A, Kumar AR: Does perioperative steroid use improve clinical outcomes in open repair of craniosynostosis? J Craniofac Surg 26:226\u2013231, 201510.1097\/SCS.000000000000140525569398"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/20\/5\/article-p410.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/20\/5\/article-p410.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/20\/5\/article-p410.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T13:58:03Z","timestamp":1681567083000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/20\/5\/article-p410.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11]]},"references-count":27,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2017.5.peds16674","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11]]}}}