Craniosynostosis is a condition characterized by the premature fusion of skull sutures, resulting in noticeable cranial deformities. Historically, strip craniectomy was a common approach. However, due to high recurrence rates, this method has fallen out of favor. Currently, a one-stage cranial remodeling strategy is more prevalent, which addresses hypoplastic and compensatory changes. For instance, the correction of sagittal synostosis involves widening the lateral skull and addressing frontal bossing and occipital bulging. Similarly, the correction of unicoronal synostosis involves advancing the affected forehead side and modifying the protrusion on the unaffected side.
In syndromic cases, there is often a reduction in the anteroposterior skull diameter and an increase in intracranial pressure. Initially, distraction osteogenesis is used to expand the posterior cranium. Subsequent surgeries involve the removal of distractors, and if necessary, frontoorbital advancement through distraction osteogenesis. Frontoorbital remodeling is an alternative for cases not requiring extension. Midface surgery is typically postponed until the child is 9-10 years old, with preference given to Le Fort III distraction. However, severe exophthalmos or compromised respiratory function may necessitate earlier intervention. Optimal timing of surgical intervention is crucial to minimize the number of surgeries and achieve favorable outcomes. There is a significant emphasis on selecting the right intervention at the appropriate age to attain optimal results.