Performance of minimally invasive sagittal synostectomy with supine patient positioning: technical note.

OBJECTIVE Minimally invasive (MI) synostectomy with postoperative helmet orthosis is increasingly used in the management of sagittal craniosynostosis. Although the MI technique reduces or eliminates the need for access to the lateral skull surface, the modified prone/sphinx position remains popular. The authors present their initial experience with supine positioning for MI sagittal synostectomy. METHODS The authors used supine positioning with the head turned laterally on a horseshoe head holder in 5 consecutive patients undergoing MI sagittal synostectomy. RESULTS Resection of the sagittal suture from the anterior to posterior fontanel was accomplished in all patients. Surgical time averaged 70 minutes. No patient required transfusion. The posttreatment cephalic index averaged 83%. CONCLUSIONS Initial experience with supine positioning for MI sagittal synostectomy suggests that the technique can be used as an alternative to the modified prone position, with the potential to reduce anesthetic risk in these patients.