What are the different types of strip craniectomies?

A strip craniectomy is surgery to remove a narrow strip of skull bone. It is used to treat craniosynostosis. Craniosynostosis is a condition in which one or more of the seams between a baby's skull bones close too early or fuse. These seams are called sutures. The sutures allow the skull to grow as the brain grows. When a suture fuses, it can limit skull growth in that area and change the shape of the head.

During a strip craniectomy, the surgeon removes bone along the closed suture. This allows the skull to continue changing shape as it grows.

The type of strip craniectomy depends on which suture is fused. Types include:

• Sagittal strip craniectomy. The sagittal suture runs from the front to the back along the top of the skull. When it closes too early, the skull grows longer and narrower. During surgery, the surgeon removes the fused sagittal suture.
• Metopic strip craniectomy. The metopic suture runs down the middle of the forehead. When it closes too early, the forehead may become narrow and triangular. During surgery, the surgeon removes the fused metopic suture.
• Coronal strip craniectomy. The coronal sutures run across the top of the skull from ear to ear. When one closes too early, it can cause uneven growth of the forehead and the area around the eye. During surgery, the surgeon removes bone along the fused coronal suture. This allows the skull to reshape as it grows.
• Lambdoid strip craniectomy. The lambdoid sutures are at the back of the skull. When one closes too early, the back of the head can become flat on that side and the skull can become uneven. During surgery, the surgeon removes bone along the fused lambdoid suture.

Strip craniectomy often is done with an endoscope. This tool helps the surgeon see the area being treated through small cuts in the scalp.

After surgery, a molding helmet may be used to help reshape the skull as it grows.

Strip craniectomy usually is done in young infants because the brain and skull grow quickly during this time. This growth helps reshape the head after surgery. Other craniosynostosis surgeries reshape the skull during the operation instead.

The surgical approach depends on the child's age and individual needs.