Prognostic and post-surgical updates in the treatment of non-syndromic craniosynostosis: a systematic review

Introduction: Craniosynostosis represents a rare congenital condition characterized by the premature fusion of one or more cranial sutures. The majority of cases of this disorder are non-syndromic in nature. Objective: This study aims to conduct an analysis and comparison of available surgical techniques, evaluating their respective postoperative outcomes in the treatment of non-syndromic craniosynostosis. The focus lies on assessing functional, aesthetic, and neurological outcomes. Methods: A systematic review was undertaken, encompassing the search for clinical trials (including randomized trials), systematic reviews, and meta-analyses available online in both Portuguese and English languages. The search terms "prognosis" and "non-syndromic craniosynostosis" were utilized along with the boolean operator "AND". Articles published between 2018 and 2023 were filtered through the Virtual Health Library (VHL) and PubMed platforms, specifically targeting studies presenting prognostic data related to craniosynostosis in pediatric patients up to 12 months of age. Results: The most favorable prognostic outcomes identified in this investigation were associated with conventional cranioplasty and minimally invasive endoscopic craniectomy techniques. Notably, conventional cranioplasty demonstrated superior intellectual outcomes among patients undergoing this procedure, with an average intelligence quotient of 111.7 ± 13 and academic performance aligning closely with national averages across various domains. Conversely, minimally invasive endoscopic craniectomy exhibited low rates of blood transfusion, complications, and reoperations. Conclusion: The findings underscore the superior cognitive prognosis associated with conventional cranioplasty, positioning it as a highly applicable surgical option for addressing craniosynostosis, supported by robust evidence.