2The International MD Program at Vita-Salute San Raffaele University, Milan, Italy
AIM: To retrospectively analyze infants treated with early surgical management using the simple excision technique and discusses the outcomes in light of the existing literature. MATERIAL and METHODS: Ten infants with OCH who underwent surgery were included in this study. The following parameters were recorded: age, sex, mode of delivery (normal vaginal delivery, cesarean section, vacuum extraction, or forceps delivery), presence of hematologic disorders or bleeding diathesis, comorbidities or anomalies, lesion localization, lesion size, duration of surgery and anesthesia, estimated blood loss, need for transfusion, postoperative complications, neurological findings, presence of additional pathologies, classification type, duration of hospital stay, and postoperative follow-up period. RESULTS: The mean age of the 10 infants was 3.7 months, with a male-to-female ratio of 9:1. The OCH was located in the occipital region in one patient, the parietal region in eight patients, and bilaterally in the parietal region in one female infant. The lesion size ranged from 37 to 90 mm. The duration of surgery ranged from 40 to 80 min, while anesthesia lasted between 70 and 120 min. The mean intraoperative blood loss was 30 mL. All patients were discharged within an average of 2 days. According to Wang’s classification, all cases were categorized as Type 1. The follow-up period ranged from 1 to 66 months. CONCLUSION: Initial management of cephalohematoma should involve careful monitoring. However, when ossification occurs, early neurosurgical intervention is advisable. Early surgical treatment of OCH using the simple excision technique is a safe, effective, and minimally invasive approach associated with short operative time, minimal blood loss, and excellent cosmetic and functional outcomes. Therefore, early surgical management should be considered the preferred treatment option for OCH.