Pioneering skull surgery for babies introduced in Glasgow

Introduced by the NHS Greater Glasgow and Clyde Craniofacial Team at the Royal Hospital for Children, parents now have the option to choose a shorter minimal access early surgery for their child suffering from Craniosynostosis, where previously they only had the option of an average six-hour long surgery.

Babies born with Craniosynostosis, a condition where a child's skull sutures fuse prematurely, can lead to an irregular skull shape and potentially hinder overall skull growth.

The skull, naturally composed of various elements, is often restricted in growth by this condition, posing possible harm to the rapidly developing brain within the early years of life.

The Scottish National Centre of Craniofacial Surgery for Children and Young People is the designated centre to manage children born with Craniosynostosis and other craniofacial conditions and is based at NHS Greater Glasgow and Clyde’s, Royal Hospital for Children.

Previously, the chief surgical treatment, referred to as open skull vault remodelling, encompassed a significant ordeal of removing and surgically reattaching skull parts, involving sizeable blood transfusions and requiring extended hospital stays of up to a week.

However, in a pioneering act in March 2023, Mr Halsnad and Mr Sangra conducted Scotland's first minimal access endoscopic surgery on a Craniosynostosis-stricken infant.

This method reduces the hospital stay to just a couple of days and involves the baby engaging in helmet therapy for 12 to 18 months to gently reshape the skull.

Mr Halsnad said: "We were aware that this surgery had been successfully taking place in America for over a decade.

"We proposed 'Glasgow Endoscopic Craniosynostosis Surgery Project' to our hospital management with its obvious benefits to patient, parents and to the service in general."

The ‘Glasgow project’ team, of which he is a part, trained in Texas under Mr David Jimenez, a paediatric neurosurgeon who pioneered this technique.

Mr Halsnad added: "Shorter craniofacial operations are likely to have fewer complications and better long-term outcomes when compared to more extensive longer surgeries.

"In addition to the benefits for the children and their care, we're able to free up surgery theatres and PICU beds that are no longer required, as well as avoid blood transfusions."

The early stage detection and referral are paramount to the success of this process.

Brothers Angus and Edward Richards (Image: Alexandra Richards)

One beneficiary of this procedure, Edward Richards, was just twelve weeks old at the time of his surgery.

By five weeks, he was referred to a GP and swiftly assigned a neurosurgeon appointment due to the shape of his head.

His mother, Alexandra Richards, said: "We could consider the endoscopic approach, or the full head reconstruction. There were pros and cons to both but, ultimately, it was very clear that if we were willing to be compliant and commit to the helmet therapy after the operation, then that was the best option for our family.

"We knew he would be okay either way, but the advantages for us with the minimally invasive approach really outweighed the full head reconstruction."

Now eight months old and thriving, Edward will be able to lead a normal and happy life once his helmet is off, only requiring routine doctor's observation.