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162Chapter10institutewereincludedPatientsolderthan14monthsatthetimeofsurgeryarerareinourinstitutionandwereexcludedTREATMENTForchildrenundertheageof6monthsEACSisperformedinourcenter8DuringEACSthefusedsagittalsutureisremovedtroughtwosmallskinincisionswiththeaidoftheendoscopeandbiparietalstaveosteotomiesareperformed(Figure1)HelmettherapystartstwoweeksafterEACSforallpatientsandcontinuesforaperiodofapproximately10monthsDuringthisperiodevery3monthsa3Dphotoismadetoevaluateheadgrowthandadjust/change/stopthehelmettherapyifneededFigure1NotablestepsinEACSfromourinstitutionTop-leftskin-incisionswithschematicoverviewofaffectedsuture(yellow)andcutting-lines(black) Top-rightexternalviewofminimallyinvasiveremovalofaffectedsutureandadditionalosteotomiesBottom-leftendoscopicviewofminimallyinvasiveremovalofaffectedsutureandadditionalosteotomiesBottom-rightresectedfusedsagittalsutureandbiparietalsidecuts