{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:37:01Z","timestamp":1789177021669,"version":"build-2803163510"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This study reports the authors\u2019 experience with surgical interventions for nonsyndromic craniosynostosis. They assessed open surgery and minimally invasive endoscopic suturectomy in terms of periprocedural outcomes and related risk factors for postoperative complications and reoperation. This study aimed to provide insights toward surgical approach decisions and lay the groundwork for future prospective studies in this field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In this retrospective cohort study, the medical records of all patients with nonsyndromic craniosynostosis who underwent primary surgery at the authors\u2019 center from 2014 to 2024 were analyzed. The authors assessed open surgery and endoscopic suturectomy based on anesthesia time, length of hospitalization, hematological parameters, postoperative blood transfusion volume, and changes in head circumference percentile (HCP). A subgroup analysis was conducted for patients younger than 6 months across different types of craniosynostosis. Further investigation was conducted to identify potential risk factors for postoperative complications and reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 633 pediatric patients treated for nonsyndromic craniosynostosis were included in this study (281 with endoscopic suturectomy, 352 with open surgery). These data indicated a growing trend for endoscopic procedures. The authors\u2019 center began performing endoscopic surgery in 2014, and by 2024, 75% of craniosynostosis patients underwent this procedure (p &lt; 0.001). Patients in the endoscopic group experienced shorter anesthesia times (p &lt; 0.001), reduced lengths of hospitalization (p &lt; 0.001), and lower blood transfusion volumes (p &lt; 0.001) compared with those in the open surgery group; however, blood transfusion volume differences were not significant in the subgroup analysis. The subgroup analysis revealed comparable HCP changes in sagittal (p = 0.4) and coronal (p = 0.85) craniosynostosis. In comparison, greater changes were noted after open surgery in cases of metopic (p = 0.03) and multisuture (p = 0.04) craniosynostosis. The rates of postoperative complications (endoscopic 6.4% and open 4.5%) and reoperation (endoscopic 4.6% and open 2.8%) were comparable between the two groups. In univariate analysis, higher weight (OR 1.07, p &lt; 0.05) was identified as the only risk factor for postoperative complications, which can be attributed to delayed surgical intervention. Coronal (OR 8.38, p &lt; 0.05) and multisuture (OR 23.66, p &lt; 0.01) craniosynostoses were associated with higher reoperation rates, while adding barrel stave osteotomies was linked to a lower reoperation rate (OR 0.22, p &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Endoscopic suturectomy is associated with acceptable periprocedural outcomes compared with open surgery, with comparable rates of complications and reoperation. These findings are supported by the subgroup analysis. However, further studies focusing on craniometric outcomes are needed, as surgical procedures have shown variable results across different types of craniosynostosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.10.focus24587","type":"journal-article","created":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T01:12:49Z","timestamp":1735693969000},"page":"E5","source":"Crossref","is-referenced-by-count":7,"title":["Eleven years of experience with endoscopic and open surgery for craniosynostosis and risk factors for undesirable outcome"],"prefix":"10.3171","volume":"58","author":[{"given":"Mohammad Amin","family":"Dabbagh Ohadi","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurosurgery, Children\u2019s Medical Center Hospital, Tehran University of Medical Sciences, Tehran;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed Farzad","family":"Maroufi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Children\u2019s Medical Center Hospital, Tehran University of Medical Sciences, Tehran;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadsadegh","family":"Talebi Kahdouei","sequence":"additional","affiliation":[{"name":"Fetal and Pediatric Cardiovascular Research Center, Children\u2019s Medical Center, Tehran University of Medical Sciences, Tehran;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyvan","family":"Tayebi Meybodi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Children\u2019s Medical Center Hospital, Tehran University of Medical Sciences, Tehran;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Mirashrafhi","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farideh","family":"Nejat","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Children\u2019s Medical Center Hospital, Tehran University of Medical Sciences, Tehran;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hojjat","family":"Zeraati","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohreh","family":"Habibi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Children\u2019s Medical Center Hospital, Tehran University of Medical Sciences, Tehran;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"J Craniofac Surg","first-page":"418","article-title":"Guideline on treatment and management of craniosynostosis: patient and family version","volume":"34","author":"Faasse M","year":"2023","unstructured":"Faasse M, Mathijssen IMJ. Guideline on treatment and management of craniosynostosis: patient and family version. J Craniofac Surg. 2023;34(1):418\u2013433."},{"issue":"4","key":"b2","series-title":"J Neurosurg Pediatr","first-page":"335","article-title":"Endoscopic surgery for nonsyndromic craniosynostosis: a 16-year single-center experience","volume":"22","author":"Dalle Ore CL","year":"2018","unstructured":"Dalle Ore CL, Dilip M, Brandel MG. Endoscopic surgery for nonsyndromic craniosynostosis: a 16-year single-center experience. J Neurosurg Pediatr. 2018;22(4):335\u2013343."},{"issue":"9","key":"b3","series-title":"Childs Nerv Syst","first-page":"1627","article-title":"Endoscopic versus open approach in craniosynostosis repair: a systematic review and meta-analysis of perioperative outcomes","volume":"34","author":"Goyal A","year":"2018","unstructured":"Goyal A, Lu VM, Yolcu YU, Elminawy M, Daniels DJ. Endoscopic versus open approach in craniosynostosis repair: a systematic review and meta-analysis of perioperative outcomes. Childs Nerv Syst. 2018;34(9):1627\u20131637."},{"issue":"4","key":"b4","series-title":"J Neurosurg Pediatr","first-page":"361","article-title":"A systematic review of endoscopic versus open treatment of craniosynostosis. Part 2: The nonsagittal single sutures","volume":"22","author":"Yan H","year":"2018","unstructured":"Yan H, Abel TJ, Alotaibi NM,  A systematic review of endoscopic versus open treatment of craniosynostosis. Part 2: The nonsagittal single sutures. J Neurosurg Pediatr. 2018;22(4):361\u2013368."},{"issue":"4","key":"b5","series-title":"J Neurosurg Pediatr","first-page":"352","article-title":"A systematic review and meta-analysis of endoscopic versus open treatment of craniosynostosis. Part 1: The sagittal suture","volume":"22","author":"Yan H","year":"2018","unstructured":"Yan H, Abel TJ, Alotaibi NM,  A systematic review and meta-analysis of endoscopic versus open treatment of craniosynostosis. Part 1: The sagittal suture. J Neurosurg Pediatr. 2018;22(4):352\u2013360."},{"issue":"5","key":"b6","series-title":"J Craniofac Surg","first-page":"1245","article-title":"Changing epidemiology of nonsyndromic craniosynostosis and revisiting the risk factors","volume":"23","author":"Lee HQ","year":"2012","unstructured":"Lee HQ, Hutson JM, Wray AC. Changing epidemiology of nonsyndromic craniosynostosis and revisiting the risk factors. 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Are endoscopic and open treatments of metopic synostosis equivalent in treating trigonocephaly and hypotelorism? J Craniofac Surg. 2015;26(1):129\u2013134."},{"issue":"2","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"105","article-title":"Comparative analysis of cranial vault remodeling versus endoscopic suturectomy in the treatment of unilateral lambdoid craniosynostosis","volume":"26","author":"Rattani A","year":"2020","unstructured":"Rattani A, Riordan CP, Meara JG, Proctor MR. Comparative analysis of cranial vault remodeling versus endoscopic suturectomy in the treatment of unilateral lambdoid craniosynostosis. 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Intraoperative and postoperative complications in the surgical treatment of craniosynostosis: minimally invasive versus open surgical procedures. J Neurosurg Pediatr. 2018;21(2):112\u2013118."},{"issue":"2","key":"b18","series-title":"Plast Reconstr Surg","first-page":"305","article-title":"A longitudinal, statistical study of reoperation rates in craniosynostosis","volume":"100","author":"Williams JK","year":"1997","unstructured":"Williams JK, Cohen SR, Burstein FD, Hudgins R, Boydston W, Simms C. A longitudinal, statistical study of reoperation rates in craniosynostosis. Plast Reconstr Surg. 1997;100(2):305\u2013310."},{"issue":"4","key":"b19","series-title":"Turk J Med Sci","first-page":"1235","article-title":"Amount of reoperation following surgical repair of nonsyndromic craniosynostosis at a single center","volume":"52","author":"Baykal D","year":"2022","unstructured":"Baykal D, Bal\u00e7\u0131n RN, Ta\u015fkap\u0131l\u0131o\u011flu M\u00d6. Amount of reoperation following surgical repair of nonsyndromic craniosynostosis at a single center. Turk J Med Sci. 2022;52(4):1235\u20131240."},{"issue":"12","key":"b20","series-title":"Childs Nerv Syst","first-page":"3983","article-title":"Experiences of surgical complications and reoperations in nonsyndromic sagittal synostosis patients in Oulu","volume":"40","author":"Svalina A","year":"2024","unstructured":"Svalina A, Serlo W, Sinikumpu JJ, Salokorpi N. Experiences of surgical complications and reoperations in nonsyndromic sagittal synostosis patients in Oulu. Childs Nerv Syst. 2024;40(12):3983\u20133991."},{"issue":"1","key":"b21","series-title":"J Neurosurg Pediatr","first-page":"86","article-title":"Less is more: does the addition of barrel staves improve results in endoscopic strip craniectomy for sagittal craniosynostosis?","volume":"20","author":"Wood BC","year":"2017","unstructured":"Wood BC, Ahn ES, Wang JY,  Less is more: does the addition of barrel staves improve results in endoscopic strip craniectomy for sagittal craniosynostosis? J Neurosurg Pediatr. 2017;20(1):86\u201390."},{"issue":"1","key":"b1","series-title":"J Craniofac Surg","first-page":"418","article-title":"Guideline on treatment and management of craniosynostosis: patient and family version","volume":"34","author":"Faasse M","year":"2023","unstructured":"Faasse M, Mathijssen IMJ. Guideline on treatment and management of craniosynostosis: patient and family version. J Craniofac Surg. 2023;34(1):418\u2013433."},{"issue":"4","key":"b2","series-title":"J Neurosurg Pediatr","first-page":"335","article-title":"Endoscopic surgery for nonsyndromic craniosynostosis: a 16-year single-center experience","volume":"22","author":"Dalle Ore CL","year":"2018","unstructured":"Dalle Ore CL, Dilip M, Brandel MG. Endoscopic surgery for nonsyndromic craniosynostosis: a 16-year single-center experience. J Neurosurg Pediatr. 2018;22(4):335\u2013343."},{"issue":"9","key":"b3","series-title":"Childs Nerv Syst","first-page":"1627","article-title":"Endoscopic versus open approach in craniosynostosis repair: a systematic review and meta-analysis of perioperative outcomes","volume":"34","author":"Goyal A","year":"2018","unstructured":"Goyal A, Lu VM, Yolcu YU, Elminawy M, Daniels DJ. Endoscopic versus open approach in craniosynostosis repair: a systematic review and meta-analysis of perioperative outcomes. Childs Nerv Syst. 2018;34(9):1627\u20131637."},{"issue":"4","key":"b4","series-title":"J Neurosurg Pediatr","first-page":"361","article-title":"A systematic review of endoscopic versus open treatment of craniosynostosis. Part 2: The nonsagittal single sutures","volume":"22","author":"Yan H","year":"2018","unstructured":"Yan H, Abel TJ, Alotaibi NM,  A systematic review of endoscopic versus open treatment of craniosynostosis. Part 2: The nonsagittal single sutures. J Neurosurg Pediatr. 2018;22(4):361\u2013368."},{"issue":"4","key":"b5","series-title":"J Neurosurg Pediatr","first-page":"352","article-title":"A systematic review and meta-analysis of endoscopic versus open treatment of craniosynostosis. Part 1: The sagittal suture","volume":"22","author":"Yan H","year":"2018","unstructured":"Yan H, Abel TJ, Alotaibi NM,  A systematic review and meta-analysis of endoscopic versus open treatment of craniosynostosis. Part 1: The sagittal suture. J Neurosurg Pediatr. 2018;22(4):352\u2013360."},{"issue":"5","key":"b6","series-title":"J Craniofac Surg","first-page":"1245","article-title":"Changing epidemiology of nonsyndromic craniosynostosis and revisiting the risk factors","volume":"23","author":"Lee HQ","year":"2012","unstructured":"Lee HQ, Hutson JM, Wray AC. Changing epidemiology of nonsyndromic craniosynostosis and revisiting the risk factors. J Craniofac Surg. 2012;23(5):1245\u20131251."},{"issue":"1","key":"b7","series-title":"J Craniofac Surg","first-page":"89","article-title":"Increased incidence of metopic suture abnormalities in children with positional plagiocephaly","volume":"22","author":"Fisher DC","year":"2011","unstructured":"Fisher DC, Kornrumpf BP, Couture D, Glazier SS, Argenta LC, David LR. Increased incidence of metopic suture abnormalities in children with positional plagiocephaly. 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J Neurosurg Pediatr. 2022;29(5):551\u2013559."},{"issue":"3","key":"b11","series-title":"J Craniofac Surg","first-page":"794","article-title":"The learning curve of a craniofacial surgeon: a retrospective study of 100 consecutive cases","volume":"33","author":"Sakamoto Y","year":"2022","unstructured":"Sakamoto Y, Miwa T. The learning curve of a craniofacial surgeon: a retrospective study of 100 consecutive cases. J Craniofac Surg. 2022;33(3):794\u2013796."},{"issue":"5","key":"b12","series-title":"J Neurosurg Pediatr","first-page":"467","article-title":"Analysis of clinical outcomes for treatment of sagittal craniosynostosis: a comparison of endoscopic suturectomy and cranial vault remodeling","volume":"22","author":"Isaac KV","year":"2018","unstructured":"Isaac KV, Meara JG, Proctor MR. Analysis of clinical outcomes for treatment of sagittal craniosynostosis: a comparison of endoscopic suturectomy and cranial vault remodeling. J Neurosurg Pediatr. 2018;22(5):467\u2013474."},{"issue":"4","key":"b13","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Quantitative and qualitative comparison of morphometric outcomes after endoscopic and conventional correction of sagittal and metopic craniosynostosis versus control groups","volume":"50","author":"Schulz M","year":"2021","unstructured":"Schulz M, Liebe-P\u00fcschel L, Seelbach K,  Quantitative and qualitative comparison of morphometric outcomes after endoscopic and conventional correction of sagittal and metopic craniosynostosis versus control groups. Neurosurg Focus. 2021;50(4):E2."},{"issue":"1","key":"b14","series-title":"J Craniofac Surg","first-page":"129","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. 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J Neurosurg Pediatr. 2020;26(2):105\u2013112."},{"issue":"4","key":"b16","series-title":"J Craniofac Surg","first-page":"1190","article-title":"Early frontofacial symmetry after correction of unilateral coronal synostosis: frontoorbital advancement vs endoscopic strip craniectomy and helmet therapy","volume":"24","author":"Tan SP","year":"2013","unstructured":"Tan SP, Proctor MR, Mulliken JB, Rogers GF. Early frontofacial symmetry after correction of unilateral coronal synostosis: frontoorbital advancement vs endoscopic strip craniectomy and helmet therapy. J Craniofac Surg. 2013;24(4):1190\u20131194."},{"issue":"2","key":"b17","series-title":"J Neurosurg Pediatr","first-page":"112","article-title":"Intraoperative and postoperative complications in the surgical treatment of craniosynostosis: minimally invasive versus open surgical procedures","volume":"21","author":"Arts S","year":"2018","unstructured":"Arts S, Delye H, van Lindert EJ. Intraoperative and postoperative complications in the surgical treatment of craniosynostosis: minimally invasive versus open surgical procedures. J Neurosurg Pediatr. 2018;21(2):112\u2013118."},{"issue":"2","key":"b18","series-title":"Plast Reconstr Surg","first-page":"305","article-title":"A longitudinal, statistical study of reoperation rates in craniosynostosis","volume":"100","author":"Williams JK","year":"1997","unstructured":"Williams JK, Cohen SR, Burstein FD, Hudgins R, Boydston W, Simms C. A longitudinal, statistical study of reoperation rates in craniosynostosis. Plast Reconstr Surg. 1997;100(2):305\u2013310."},{"issue":"4","key":"b19","series-title":"Turk J Med Sci","first-page":"1235","article-title":"Amount of reoperation following surgical repair of nonsyndromic craniosynostosis at a single center","volume":"52","author":"Baykal D","year":"2022","unstructured":"Baykal D, Bal\u00e7\u0131n RN, Ta\u015fkap\u0131l\u0131o\u011flu M\u00d6. Amount of reoperation following surgical repair of nonsyndromic craniosynostosis at a single center. Turk J Med Sci. 2022;52(4):1235\u20131240."},{"issue":"12","key":"b20","series-title":"Childs Nerv Syst","first-page":"3983","article-title":"Experiences of surgical complications and reoperations in nonsyndromic sagittal synostosis patients in Oulu","volume":"40","author":"Svalina A","year":"2024","unstructured":"Svalina A, Serlo W, Sinikumpu JJ, Salokorpi N. Experiences of surgical complications and reoperations in nonsyndromic sagittal synostosis patients in Oulu. Childs Nerv Syst. 2024;40(12):3983\u20133991."},{"issue":"1","key":"b21","series-title":"J Neurosurg Pediatr","first-page":"86","article-title":"Less is more: does the addition of barrel staves improve results in endoscopic strip craniectomy for sagittal craniosynostosis?","volume":"20","author":"Wood BC","year":"2017","unstructured":"Wood BC, Ahn ES, Wang JY,  Less is more: does the addition of barrel staves improve results in endoscopic strip craniectomy for sagittal craniosynostosis? 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