(1) Background: Fetal surgery for meningomyelocele (MMC) should reduce the occurrence of Arnold–Chiari malformations, hydrocephalus, the associated need for craniocervical decompression, and the need for cerebrospinal fluid shunt insertion. Fetal surgery should improve ambulatory status. (2) Methods: We used retrospective analysis of the documentation and descriptive statistics to summarize the clinical data and measured MRI parameters. The neurosurgical results are presented as the frequency of findings in percentages and compared with the results of the Management of Myelomeningocele Study (MOMS). (3) Results: A total of eight patients who underwent prenatal correction of MMC between 2016 and 2020 participated. MRI detected Chiari II malformation in all patients during prenatal imaging and in 87.5% of the patients at the age of 12 months. Craniocervical decompression was used in 25% of the patients. Shunt-dependent hydrocephalus occurred in 50% of the cases. In 87.5% of the cases, the functional level exceeded the expected ambulatory status. (4) Conclusions: We present the clinical status of our patients. Analysis of the complete cohort confirmed that prenatal surgery is associated with a reduced occurrence of Chiari malformations and reduced associated occurrence of hydrocephalus. Specific lesion levels are not associated with the need for craniocervical decompression. The results of our study are valuable in prenatal counseling and important for treatment planning.

Aim of the study. The goal of the present study was to analyse the exclusive use of absorbable suture material (Vicryl) in the fixation of transposed bone segments in cranial vault reshaping without modification of the osteotomy design. Clinical rationale for the study. In the surgical correction of craniosynostosis, bone fixation using osteosynthesis is a key step. Absorbable osteosynthesis is a widespread tool in cranial vault remodelling, but only a limited number of studies have described the use of absorbable sutures in the treatment of patients with craniosynostosis. Materials and methods. In 72 children with various types of craniosynostosis, up to 24 months of age, osteosynthesis was conducted exclusively with Vicryl sutures. All patients were evaluated for the stability of postoperative results, and foreign body reactions were examined as part of the routine clinical and radiological follow-up ranging from 1 to 36 months. Results. All examined children exhibited stable postoperative conditions with immediate stability of all remodelled cranial vaults. 2D and 3D radiological examinations demonstrated good bony union in all cases. Significant foreign body reactions were not observed and bone healing was noted at all sites. Conclusion and clinical implications. The exclusive application of absorbable suture material enables stable and cost-effective osteosynthesis in craniofacial surgery without altering the osteotomy design.

Objectives: Positional deformity (PD), also known as deformational plagiocephaly or non-synostosis, is a primary cause of abnormal head shape and asymmetry in infants. The most common type, occipital plagiocephaly, leads to flattening of one side of the back of the head or the entire head (positional brachycephaly). PD results from external forces on the growing skull, often due to childbirth and improper positioning during sleep. The incidence is approximately 1 in 300 births, with prevalence peaking between the seventh week and four months of age. Our objective was to monitor craniofacial parameters in patients with positional deformity (PD), to evaluate cranial asymmetry and PD severity, and to determine the relationship between craniofacial asymmetry and PD severity. Methods: This study included patients from the Department of Pediatric Neurosurgery at the National Institute of Children’s Diseases and the Faculty of Medicine, Comenius University in Bratislava, Slovakia. Craniofacial parameters on the right and left sides of the face were examined. Results: Significant differences were found in the upper and middle thirds of the face, indicating a strong association between positional deformity and facial asymmetry. Conclusions: the findings contribute new insights into craniofacial anthropometry and neurosurgery, enhancing the diagnosis of positional deformity in Slovakian patients.

Over the last decade, rapid advances in three-dimensional digital technologies have revolutionized the daily practice of pediatric craniofacial surgery, in general, and craniosynostosis surgery, more specifically. As with any new technological tool, they have been welcomed by pediatric craniofacial teams, who have found several useful applications in open craniosynostosis surgery, such as modeling craniofacial osteotomies. In this review, we analyzed the implementation of computer-assisted virtual planning in open cranial vault reconstruction for the surgical management of children with craniosynostosis, sometimes with the use of intraoperative navigation. Additionally, we documented the most common applications of virtual surgical planning technology in open craniosynostosis surgery, including modeling craniofacial osteotomies and manufacturing patient-specific biodegradable implants. We described the specific surgical workflow based on the virtual planning process. Finally, we presented some advantages and some limitations of these technological tools.