The Cleft Palate–Craniofacial Journal – Craniosynostosis, a congenital defect that occurs in infants, has become increasingly prevalent over the past two decades. This condition, which involves premature fusion of the cranial suture, may be associated with elevation in intracranial pressure. Craniosynostosis occurs in 3 to 13 out of every 10,000 live births and treatment within the first year is highly recommended.

The article “Is There an Increasing Regionalization of Surgical Repair of Craniosynostosis Procedures Into Teaching Hospitals? Implications of Regionalization” in The Cleft Palate–Craniofacial Journal examines how this complex treatment is being performed. In a retrospective study, data collected from 2003 to 2010 compare the number of craniosynostosis surgeries performed in nonteaching versus teaching hospitals. During the seven-year study period, 19,417 patients aged up to 3 years underwent surgery for their craniosynostosis.

Between 2003 and 2010, the percentage of surgeries that occurred in teaching hospitals increased from 83.3% to nearly all (97.5%) procedures performed. The authors noted that the surgeries performed in a specialized hospital were a main focus for the surgical team, so both the mortality rates and length of time patients had to remain in the hospital postoperatively were shorter, and patients had an overall better surgical outcome. Some patients experienced problems with procedures performed in a specialized facility; for example, if a facility was located far away from the patient’s home, this distance led to a lack of postoperative continuity of care.

In general, it was found that there is an increased regionalization when it comes to the surgical repair of craniosynostosis. The authors have found that surgeons who specialize in this procedure work in specialty facilities, where nearly all craniosynostosis procedures are performed. More research is necessary to see the full implications of what this will mean and if more highly trained, specialized surgeons will result in better outcomes for infants with craniosynostosis.

Full text of the article “Is There an Increasing Regionalization of Surgical Repair of Craniosynostosis Procedures Into Teaching Hospitals? Implications of Regionalization,” The Cleft Palate–Craniofacial Journal, Vol. 53, No. 2, 2016, is available at http://www.cpcjournal.org/doi/full/10.1597/14-327.

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