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A Novel VSP Technique Improves Outcomes in Endoscopic Suturectomy for Coronal Craniosynostosis
Theresa K. Webster
*, Naikhoba Munabi, Thomas A. Imahiyerobo
Plastic and Reconstructive Surgery, New York Presbyterian Hospital, New York, NY
Background: Identifying the coronal suture endoscopically can be challenging yet few studies have evaluated using virtual surgical planning (VSP) guidance. We sought to compare operative outcomes following VSP-guided and non-VSP guided endoscopic suturectomy for patients with coronal craniosynostosis.
Methods: Patients who underwent endoscopic-assisted suturectomy for uni- or bicoronal craniosynostosis from 2020 to 2024 were retrospectively reviewed. In one cohort, a surface marking guide developed with VSP facilitated identification of the coronal suture. Patient demographics, estimated blood loss, operative time, and length of stay were compared.
Results: 17 patients were included undergoing 12 unilateral and 5 bilateral suturectomies. Eight patients (4 unicoronal and 4 bicoronal) were in the VSP cohort and 9 patients (8 unicoronal and 1 bicoronal) were in the non-VSP cohort. Overall EBL for unilateral cases was 12.1 +/- 7.5 mL. Patients who underwent VSP had equivalent EBL to the non-VSP cohort (10.0 +/- 1.0 mL vs 13.1 +/- 19.2 mL, p = 0.53). For bilateral cases, EBL for the VSP cohort was 28.8 +/- 30.9 mL compared to 50 mL for the one bilateral non-VSP guided case. Patients who had VSP guidance had significantly reduced operative time for unilateral cases (63+/-17 minutes vs 81+/- 20 minutes, p < 0.01). For bilateral cases, VSP guidance was 78 +/- 26 minutes compared to 118 minutes for the one bilateral case with non-VSP guidance.
Conclusions: Using VSP to assist endoscopic coronal suturectomy reduces operative time which likely reflects a decreased reliance on intraoperative assessment and increased fidelity of neo-suture placement.
