Two Decades of Craniosynostosis Surgery: Experience and Outcomes From the National Craniofacial Center in Oman

Abstract

Objective

To evaluate the demographic characteristics, surgical approaches, and short- and long-term outcomes of patients undergoing craniosynostosis (CS) at a national referral center over a 20-year period.

Design

Retrospective cohort study.

Setting

National Craniofacial Center, Khawlah Hospital.

Participants

All patients who underwent surgical correction for CS between January 2004 and December 2023 were included.

Interventions

Patients were managed according to a standardized multidisciplinary institutional protocol involving craniofacial plastic surgery and neurosurgery. Surgical interventions included open cranial remodeling procedures—most commonly fronto-orbital advancement—and suturectomy.

Main Outcome Measure(s)

Demographic data, suture involvement, syndromic association, operative details, perioperative complications, and long-term outcomes were analyzed.

Results

A total of 124 patients were identified; 58.1% were male, and 56.5% had nonsyndromic CS. Multisuture involvement was the most common presentation (39.5%). Most patients underwent surgery between 4 and 12 months of age. Open cranial remodeling was performed in 56.5% of cases, while 11.3% underwent suturectomy. Intraoperative complications were predominantly dural injuries (41.9%), with sagittal sinus injury occurring in 2.4%. Postoperative complications included fever (48.4%) and subgaleal collection (4.8%). There was no perioperative mortality. Long-term follow-up of up to 6 years demonstrated residual cranial deformity in 28.2% and palpable fixation devices in 22.6% of patients.

Conclusions

This 20-year institutional review represents the largest national series of surgically managed CS in Khawlah Hospital. Surgical management achieved favorable outcomes with low morbidity and no mortality. Ongoing multidisciplinary collaboration remains essential to optimize long-term results.