Endoscopic Suturectomy and Molding Helmet Therapy for the Treatment of Common Types of Craniosynostosis

Abstract

Abstract Craniosynostosis, the premature fusion of one or more cranial sutures, has traditionally been corrected through open cranial vault remodeling, an effective but morbid procedure associated with prolonged operative times, substantial blood loss, and multi-day hospitalization. Endoscope-assisted strip craniectomy combined with postoperative molding helmet therapy has emerged as a minimally invasive alternative for carefully selected infants, harnessing the rapid brain growth of early infancy to guide cranial reshaping once the fused suture is released. This article reviews the evidence supporting endoscopic suturectomy across the suture phenotypes, addressing patient selection, operative timing, surgical technique, and the central role of postoperative orthosis. Suture-specific outcomes for sagittal, coronal, lambdoid, and metopic synostosis are examined alongside comparative perioperative, morphologic, and cost data relative to open remodeling. Early diagnosis and timely referral remain definitively essential to this technique, as the treatment window is narrow, while future research regarding long-term, suture-specific outcomes is still needed.