Isolated craniosynostosis usually does
not interfere with airway management, but it may be associated with other
craniofacial abnormalities. Raised intracranial pressure can occur secondary
to fused cranial sutures. If more than two sutures are affected, up to 38%
of patients will have
increased intracranial pressure. Cranial vault reconstruction involves
large volume blood product transfusion and risk of air embolus.
Large-bore venous access and invasive pressure monitoring is therefore recommended.
Congenital
heart disease may be associated with this syndrome, and the patient should
be evaluated appropriately (history and physical examination,
electrocardiogram, echocardiogram). Considerations for the patient with a
congenital cardiac lesion include knowledge of the anatomy and
pathophysiology, subacute bacterial endocarditis prophylaxis, and strict avoidance of air embolus.
Mental retardation and hearing loss may compromise cooperation.