Craniosynostosis is a rare condition but common referral to craniofacial units worldwide. Craniosynostosis affecting a single suture in the absence of an overlaying syndrome is a relatively straightforward clinical diagnosis and operative management is rarely altered by unexpected abnormalities, yet, CT-scans are routine in the work up of such patients in our unit. Are these scans necessary?
All first presentations (855) to the Auckland Regional CranioFacial Unit over the 10 year period 2008-17 were assessed. Electronic records were reviewed for clinical diagnosis, CT-scan report and operative findings. Australasian CranioFacial units were surveyed about their management of such patients. 94 patients met inclusion criteria (single-suture, non-syndromic, underwent surgery for craniosynostosis) and 100% underwent CT-scans. 58/94 underwent CT-scans following clinical diagnosis allowing comparison: there was 100% concordance between clinical and radiological diagnosis. Available CT-scan reports (89/94) revealed 3 unexpected findings, none of which altered surgical management.
Clinical diagnosis alone of isolated craniosynostosis in the Auckland Regional CranioFacial unit is accurate and CT-scans have not altered surgical management in the audit period. CT-scans are unnecessary in the clinical work up of single-suture non-syndromic craniosynostosis. Australasian CranioFacial consistently request CT-scans for the diagnosis and surgical planning of single-suture non-syndromic craniosynostosis.