Nonsyndromic Craniosynostoses

Surgery for craniosynostoses can be conceptualized as surgical jazz, requiring not only familiarity with techniques but also intraoperative improvisation. Surgery for nonsyndromic craniosynostosis is done primarily for cosmesis, but the alleviation of intracranial hypertension due to craniocerebral disproportion may be required. Hydrocephalus is rare, but, if present, will require CSF diversion. There are two broad categories of surgery, osteoclastic techniques, in which bone is removed to allow normal growth and self-improvement of contour, and remodeling techniques, which reconstruct cranial bone to establish a more aesthetic contour. Acting on a belief that there exists a correct surgical routine for each named disorder will often result in suboptimum outcome. No two nonsyndromic patients are identical, and therefore, knowledgeable and experienced surgeons do not perform the same surgery for each diagnosis. Each patient requires a case-specific approach. Also, the timing of surgery varies with developmental age, diagnosis, and neurosurgeon.