Introduction:

Reporting two cases with trigonocephalus, treated by open and endoscopic surgery.

Materials and Methods:

Craniosynostosis refers to premature fusion of one or more cranial vault sutures. Trigonocephaly is the second most frequent type of craniosynostosis and is associated with a remarkable occurance of intracranial abnormalities and neuropathology. Patients with metopic craniosynostosis are traditionally treated with fronto-orbital advancement to correct hypotelorism and trigonocephaly. Alternatively, endoscopic-assisted treatment comprises narrow osteotomy of the fused suture followed by postoperative helmet therapy.

Results:

The first patient is a first-born 6-month old male to healthy parents. After he was diagnosed as trigonocephaly he underwent surgery under general anesthesia. Open surgery was performed. Postoperatively the patient was monitored in the intensive care unit and was discharged 3 days later with no complications. Second year control images revealed physilogical formation of cranium. The second patient is a 3-month old male, in whom the vaginal delivery was at 40 weeks of gestation. After he was diagnosed as trigonocephaly he underwent surgery under general anesthesia. Endoscopy assisted microsurgery was performed. Postoperatively the patient was monitored in the intensive care unit and discharged 3 days later with no complications. Early cranial CT showed no extra complications and trigonocephalus getting better.

Conclusion:

Endoscopy assisted surgery is safe and efficient while allowing shorter operative times, reduced costs due to decreased hospital stay, and fewer blood transfusions. However, minimally invasive treatment is only possible in cases with early diagnosis and cooperation in using a postoperative helmet therapy.

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