How I do it. 3D endoscopic treatment of metopic craniosynostosis through a single incision.

Abstract

Endoscopic approaches for craniosynostosis are a growing field in pediatric neurosurgery. In metopic synostosis, previous reports for complete fronto-orbital remodeling have proposed an intervention with multiple incisions (bregmatic, tarsal, and preauricular) to open frontonasal and frontoethmoidal synostotic sutures, and orbital roof. We propose a technique to complete all these osteotomies with a unique incision anterior to the bregmatic fontanel under 3D endoscopic vision, and review possible complications, limits, and pitfalls. Under endoscopic assistance, a complete fronto-orbital remodeling could be completed with a unique incision without mayor drawbacks.