203. Comparing Use of Sonopet(©) Ultrasonic Bone Aspirator to Traditional Instrumentation for Endoscopic Suturectomy

Authors: Gary Kocharian, MD; Gary Kocharian, MD; Ishani Premaratne, BS; Ashley O'Connor, NP; Corinne Rabbin-Birnbaum; Thomas Imahiyerobo, MD; Caitlin Hoffman, MD (New York, NY)

Introduction:

The goal of endoscopic treatment for craniosynostosis is to remove the fused suture and achieve calvarial remodeling with external orthosis. To reduce the need for secondary surgery and to minimize blood loss, instruments that maximize bone removal while minimizing blood loss and morbidity are evolving. We assess our experience with the Sonopet Ultrasonic Bone Aspirator for endoscopic suturectomy compared to traditional instrumentation at our institution.

Methods:

Retrospective chart review of consecutive endoscopic suturectomies performed from 2015 - 2019 at Weill Cornell Medicine was conducted including demographics, cephalic index, surgical indications, operative time, cosmetic results, complications, estimated blood loss (EBL), re-operation rate, length of stay, and length of helmet therapy. These variables were compared between Sonopet and non-Sonopet cohorts.

Results:

Of the 59 endoscopic suturectomy cases, 15 (25%) utilized the Sonopet (12 (80%) metopic; three (20%) coronal.)  Of the non-Sonopet cases, 26 (59%) were sagittal,, nine (20.5%) metopic, seven (16%) coronal, and two (4.5%) lambdoid. Mean operative time was 2.77 ± .09 hours with the Sonopet compared to 3.16 ± .07 hours (p = 0.0168) without the Sonopet. EBL was 17.9 ± 6.3 cc with vs. 34.6 ±11.1 cc (p = 0.0926) without the Sonopet, respectively. Length of stay and duration of helmet therapy was similar in both groups. There were no reoperations in the Sonopet group, and 3 reoperations in the non-Sonopet group with a mean follow up of 9.18 months Reoperations occurred in 1 sagittal and 2 coronal synostosis patients.

Conclusion:

Use of the Sonopet resulted in a significant decrease in operative time. Lower EBL and reoperation rates with comparable LOS and helmet therapy were also seen. This modality should be considered in appropriate endoscopic synostosis cases.