Comparison of open versus minimally invasive craniosynostosis procedures from the perspective of the parent.

Craniosynostosis, or the premature closure of the sutures of the skull, has historically been repaired in an open manner and included extensive cranial reconstruction. In recent years, technological advancements have given surgeons the ability to perform repairs with minimal surgical invasion. With the advent of endoscopy and bioresorbable plates, recent reports [J Craniofac Surg 2002;13(4):578-82] have emphasized attempts at decreased morbidity. Recently, researchers have been able to compare the results of traditional open and minimally invasive techniques in 45 craniosynostosis cases, demonstrating decreased operating room time, blood loss, transfusions, complications, and hospital stay in minimally invasive patients [Clin Plast Surg 2004;31(3):429-42]. Many of the parameters comparing the 2 types of procedures are easily quantified and comparable, but a variety of other considerations, such as the parent's reaction to the stress of surgery, arise. The purpose of this study was to compare the effects of these surgical procedures on the parent's level of stress at the time of operation. To accomplish this, we measured stress postoperatively using the Parenting Stress Index-Short Form. Subjects undergoing surgical treatment of craniosynostosis were placed into 2 groups: open versus minimally invasive. To test for confounding factors, subjects were subcategorized for sex, parent's sex, ethnicity, and parent's marital status. Analysis of our data reveals a statistically significant decrease in total stress in the households of minimally invasive patients.