Sagittal Suture Synostosis: Key Points for Surgeons and Management Principles (Diagnosis, Surgical Considerations and Timing)

Sagittal synostosis (SS) is the most common surgically treated form of craniosynostosis and possesses a strong male sex predilection. It is classically associated with scaphocephaly, with frontal and occipital bossing and biparietal narrowing. Most cases are isolated and sporadic, but a small percentage can occur in the context of a genetic syndrome or in association with the closure of other sutures. The primary indication for surgical correction is a cranial deformity, but a substantial fraction of patients who remain untreated after the age of 1 year develop intracranial hypertension. The endoscopic and open treatment options for SS are robust and all demonstrate high rates of cosmetic efficacy and cranial expansion. Ideal operative treatment should be weighed for each patient based on the age and nature of the deformity, potential for cranial orthosis compliance, familial concerns regarding anesthesia, cost, evidence of elevated intracranial pressure, and transfusion risks.