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Sagittal craniosynostosis, also known as scaphocephaly or boat-shaped head, occurs when the sagittal suture closes prematurely. Its incidence in Western populations is approximately 1 in 2,000 to 5,000 births, while in other regions, it is less common but remains the most frequent type of craniosynostosis. Affected children often have a narrow head width, a prominent forehead, a high forehead, a flattened back of the head, and it is more common in boys.
Diagnosis typically requires expertise from pediatric surgeons or pediatric neurosurgeons. If surgery is suspected, a computed tomography (CT) scan can confirm the early closure of the sagittal suture. However, not all cases are immediately obvious.
Positive signs include:
Premature closure of cranial sutures can sometimes lead to increased intracranial pressure. In affected infants, the risk of elevated intracranial pressure ranges from 0% to 18%.
Etiology is inherited in 2-8% of cases, with most causes remaining unclear. Other factors, such as vitamin D deficiency or hydrocephalus, can mimic the appearance of scaphocephaly.
The decision for surgery in children with boat-shaped heads is made by parents based on medical recommendations. Surgery is generally advised if intracranial pressure is elevated; otherwise, it may address appearance and reduce future risks. Pediatric surgeons worldwide follow similar criteria for guidance.
Standard surgery for scaphocephaly occurs around one year of age and involves reshaping the entire skull. The optimal time for intervention is about 2-3 months, with outcomes varying by individual. Many parents report high satisfaction with minimal procedures.
Endoscopic craniectomy: Performed at 2-4 months, with small incisions behind the hairline and at the back. It uses an endoscope to remove the fused suture.
Total cranial vault remodeling: Done at 10-12 months, reshaping the skull from front to back with pediatric neurosurgery assistance.
Standard skull models, based on normal infant head shapes, guide these procedures to minimize risks and shorten surgery time.
In endoscopic procedures, infants wear helmets post-surgery for head shaping. Outcomes show restored head shape with high family satisfaction.
Tracking over several years indicates improvements in head shape, with endoscopic methods gaining recognition for early intervention in sagittal craniosynostosis.