Lambdoid Sutures Synostosis: Key Points for the Neurosurgeons, Management Principles (Diagnosis, Surgical Principles and Their Rationale, Timing)

Based on personal experience and medical literature, the author reviews current data regarding the anatomy, embryology, and physiology of the lambdoid suture, and the pathology and pathophysiology of lambdoid synostosis (LSy) and its consequences. He then describes the positive and differential diagnosis of unilateral and bilateral LSy. Finally, he discusses the rationale for surgery and depicts the different surgeries that can be proposed for LSy, according to pathology, age, and clinical presentation. These techniques are documented with preoperative, peroperative, and postoperative illustrations. He discusses their advantages, drawbacks, and preferred indications and highlights technical pitfalls and their avoidance.