"It all began when Luis Carlos was born and, in an initial examination, when palpating his little head, the pediatrician noted that our child had fused fontanelles". This is how Patricia recalls the moment when, for the first time, her referring doctor told them that their baby may have a skull deformity. "Our doctor warned us that it could be a case of craniosynostosis and he told us to keep an eye on and measure our baby's head. Two weeks later, he saw that the sagittal sutures were fused and he had a CT scan carried out, the result of which confirmed the diagnosis".
The doctors explained to Patricia and her husband that the solution for their child's problem was neurosurgery and that it needed to be performed early. "At that time, we started to think about leaving our country and asking for a second opinion, as the Dominican Republic has good neurosurgeons, but hardly any pediatric specialists," explains the child's mother. From Santo Domingo, and through their insurance company, the family was advised to travel to the United States or Europe if the baby needed an operation.
During that period, they contacted SJD Barcelona Children's Hospital to ask the centre for a second opinion. "They contacted us because I had previously operated on a patient from Central America in a similar case," explains José Hinojosa, head of the Pediatric Neurosurgery Department. "There were differences of opinion between our hospital and others with regard to age and technique used: we use several techniques and we try to operate optimally when the baby is around four months old."
Surgical intervention as early as possible is essential in cases of craniosynostosis
The neurosurgeon explains that the infant had been correctly diagnosed in the country of origin. "Craniosynostosis is the early fusing of the sutures on the skull which gives rise to a deformity and an increase in cerebral pressure. So it was a good thing that they detected it straight away, since children who suffer from it must be operated on as soon as possible," explains Hinojosa. The surgical technique used to address the cases of these patients depends on the hospital and the type of deformity that the children have.
At SJD Barcelona Children's Hospital, children undergo surgery preferably between the ages of three and five months. The problem is usually corrected by endoscopy, a minimally invasive technique with excellent results. In this case, as we were dealing with a child over six months old, another less common technique was chosen, which meant breaking away from those that have been used for years. "We used the H and Ω (Omega) technique, and were able to return the skull to its normal proportions, resolve the problem of increased cerebral pressure and, very importantly, reconstruct the skull so that there were no defects after the operation," explains José Hinojosa, the Hospital's Head of Neurosurgery. Timely surgical intervention on these patients also allows for a good outcome from a cosmetic perspective.
"Thanks to the support of a fantastic, expert anaesthetic team and a top-level Pediatric ICU, our hospital can perform the surgery at around six months of age. In fact, this is complex surgery that we carry out relatively routinely and with good results," concludes Hinojosa. The data support this: in 2020 alone, more than 50 craniosynostosis procedures have been performed, with a success rate of 99%, relatively fast recovery times, and hardly any complications. Little Luis Carlos is fine example, since he was discharged only five days after surgery due to his excellent progress.
"We spend a few months asking pediatric neurosurgeons for a second opinion and we are delighted that our son finally had his operation here," affirms Luis Carlos' mother. "Using drawings, the doctor explained to us how they were going to operate on Luis, and he made us feel really calm, because when they tell you that they are going to operate on your baby's little head, it comes as a bit of a shock. But everyone gave us lots of information and we are really satisfied," Patricia sums up, adding that travelling for an operation during the pandemic has not been easy, but that they received the support they needed from the International Patient Care Team. "The warm welcome and personalised treatment really made us feel at home, from the moment we arrived in Barcelona until the day we left."