We understand that you may be feeling anxious about your child’s diagnosis and treatment. At Cincinnati Children’s, experienced doctors and surgeons will be supporting you every step of the way.

Once we determine what type of craniosynostosis your child has, our team will work with you to choose the right treatment plan for your child’s needs. Craniosynostosis treatment involves surgery to open and expand the fused skull bones. The type of surgery we recommend will depend on your child’s age and specific diagnosis.

While there can be time sensitivity for specific procedures, we won't rush decisions. We want to create a safe, effective plan that tailored to your child’s specific needs.

Minimally Invasive Surgery

Depending on your child’s age and diagnosis, we may be able to use a minimally invasive surgery. This procedure is called an endoscopic-assisted craniectomy or strip craniectomy. This procedure is ideal for children presenting younger than 4 months.

During the surgery, the surgeon makes small incisions on the top of your baby’s head. The surgeon will operate on the skull bones beneath the scalp with the aid of a thin tube camera (endoscope).

For a few months after the surgery, your child will wear a custom-made helmet. The helmet will gently mold your child’s head into a more normal shape as the brain grows.

Open Surgery

If your child needs open surgery, we’ll use our virtual surgical planning (VSP) technology before their surgery and during it while in the operating room.  This allows us to better prepare for your child’s surgery, so we know every step we’ll need to take during the operation. The VSP will also give you a picture of what your child’s head shape will look like after the procedure.

The type of surgery we choose for your child will depend on the specific diagnosis. Surgery options can include:

  • Cranial vault reconstruction (CVR) – This procedure reshapes and expands skull bones. We may do CVR on the entire skull or in individual sections. For example, if your child has fused bones at the back of the skull, we may use a version of this procedure called posterior vault remodeling or posterior vault reshaping. Some patients may also need fronto-orbital advancement (FOA) after a CVR, which reshapes the skull bone around the eyebrows. Sometimes this procedure is called vault reconstruction, cranial vault remodeling or cranial reconstruction.
  • Cranioplasty – This surgery repairs skull defects or holes. We may repair the skull with your child’s original bone (autologous cranioplasty) or use artificial bone (skull allograft implant).
  • Cranial spring surgery – With this procedure we’ll place stainless steel springs in the skull during the surgery to create more space for the brain to grow. We’ll remove the springs a few months later. This procedure is also called spring mediated cranioplasty or sagittal springs.
  • Posterior vault distraction (PVR) – We use this surgery to help expand the back of the skull. We’ll separate the skull during the procedure and insert expanders/distractors secured by screws that slowly but dramatically expand the size of the skull. Over time, the bone will grow back into this expanded area. Once enough bone grows back, we’ll remove the screws and devices. Most kids who undergo PVR go on to have other surgeries, such as CVR. This surgery is also called cranial vault distraction or cranial distraction.