The Department of Neurological Surgery's Pediatric Division is an active participant in the Cleft-Craniofacial Center at Children's Hospital of Pittsburgh. Children with presumed synostosis of a single suture, such as the sagittal suture, undergo an initial neurosurgical evaluation. Children with complex synostosis are evaluated by the entire craniofacial team, which includes consultants from plastic surgery, ophthalmology, genetics, oral-maxillofacial surgery, dentistry and otolaryngology.

After an evaluation by the craniofacial team and performance of detailed 3-dimensional craniofacial imaging studies, the team meets to discuss the appropriate treatment options in order to optimally tailor the therapeutic approach to the child’s craniofacial problem. Treatment decisions are made after a thorough discussion with the family about the risks and benefits of the various surgical and non-surgical treatment approaches.

Ongoing studies are examining the efficacy of molding orthoplastic helmets as an alternative to surgery in patients with deformational skull anomalies and exploring the utility of endoscopy as a means for optimizing the cosmetic outcome in patients with coronal synostosis. Because children with complex synostosis often require a staged approach to the treatment of their cranial, midfacial and lower facial deformities, close multidisciplinary follow-up is maintained throughout childhood and adolescence in order to optimize long-term functional and cosmetic outcome.