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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0045-1812015
Original Article

A Novel Cut-out Syringe Scalp Retractor for Endoscopic Strip Craniectomy for Craniosynostosis—A Cost-effective and Durable Alternative

Authors

  • Amol Mittal 

    1   Department of Neurosurgery, Queen's Hospital, Romford, United Kingdom

  • Rakesh Mishra 

    2   Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

  • Ranjith Chegondi 

    2   Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

  • Hrishikesh J. Patel 

    2   Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

  • Adesh Shrivastava 

    2   Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Abstract

Aim

Unilateral coronal craniosynostosis is the second most common subtype of nonsyndromic craniosynostosis. Endoscopic repair requires a scalp and dural retractor for adequate visualization and performing strip craniectomy. We describe the application of a novel cut-out syringe scalp retractor for endoscopic repair of unilateral coronal craniosynostosis.

Background

A 3-month-old female child presented with a progressive abnormal head shape. Three-dimensional reconstruction of brain CT showed a right fused coronal suture with ipsilateral temporal and contralateral frontal prominence. A diagnosis of unilateral coronal synostosis was made. The patient underwent endoscopic strip craniectomy using a novel cut-out syringe scalp retractor. The craniectomy extended from the right squamosal suture to the anterior fontanelle. The postoperative recovery was uneventful.

Discussion and Conclusion

The main aim of endoscopic surgery is to swiftly address the progression of calvarial and facial dysmorphism. The timings of endoscopic repair are crucial and usually performed before 3 months of age. It has a distinct advantage over open repair owing to shorter hospital stays, less bleeding, lower operative times, comparable aesthetic outcomes, and being minimally invasive. For endoscopic repair, various retractors have been described in the literature but these retractors are difficult to procure in resource-constrained setup. We advocate the usage of a cost-effective, durable, reusable, and malleable scalp retractor whose cost is nominal. It can be safely sterilized or can be newly made for every case. We found this retractor to be extremely useful in the case of endoscopic strip craniectomy.

Keywords

coronal craniosynostosis - endoscopic repair - syringe retractor - novel technique - strip craniectomy

Authors' Contributions

A.S. and A.M. contributed to the conception and design of the work. A.M., H.P., and R.C. were responsible for data collection, while R.M., H.P., and R.C. carried out data editing and analysis. H.P., A.M., and R.C. drafted the article, and A.S. and R.M. performed the critical revision. The final version was reviewed by A.S.


Patient's Consent

Full and detailed consent from the patient/guardian has been taken. The patient's identity has been adequately anonymized. If anything related to the patient's identity is shown, adequate consent has been taken from the patient/relative/guardian. The journal will not be responsible for any medico-legal issues arising out of issues related to the patient's identity or any other issues arising from the public display of the images/video.




Publication History

Article published online:
25 September 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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