Sagittal Suture Synostosis: Surgical Technique in Older Children

Sagittal suture craniosynostosis is the most common type of isolated premature cranial suture fusion, and multiple surgical methods have been developed to correct this deformity with increasing safety and success in recent decades. The majority of surgical techniques to address this issue have been developed for young children <6 months old to take advantage of the higher calvarial growth velocity at this age and to potentially reduce the long-term neurocognitive effects these deformities are associated with. In patients who present late, ~1 year of age or later, the surgical options are more restricted due to differences primarily in thickness of the bone and in skull bone growth rates as children age. This chapter aims to demonstrate the surgical workup, intervention, and postoperative care for older children with sagittal synostosis treated at our institution based on our extensive experience with a collaborative craniofacial team.