Simple and complex craniosynostosis are referred to the Department of Pediatric Neurosurgery as the regional coordinator center for neurosurgical and maxillo-facial disease for the pediatric age.

Patients are referred either from the family pediatrician or from another hospital. Communication with the referral centers or pediatricians is continuous. Initial assessment happens in outpatient’s clinic and after the first evaluation the patient can be advice for further diagnostic investigations, planned for surgery, or clinical follow up. Complex cases are routinely collectively discussed, plan treatment strategy is agreed among physicians and lastly discussed with the family. Specialties involved include, beside the neurosurgeon, maxillo-facial surgeon, radiologist, prenatal diagnostic, genetist, ophthalmologist, ENT, plastic surgeon, neuroanesthesist, neonatologist, pediatrician, neurologist, audiologist, speech and language therapist, dietician, physiotherapist, psychologist.

After surgery, patient is transferred to NICU or PICU only if specific indications arise, in all other the cases patients are transferred to ordinary ward. In this setting the child has at least one of the parents on her/his side all day and night until discharge. The admission happens in a dedicated ward with trained nurses.

The Neurosurgery Department is involved in the regional registry for rare disease (Registro Toscano Malattie Rare - www.rtmr.it) and take part into the neurosurgical specialist training. Specialist trainees are exposed to craniosynostosis as part of their training and involved in clinical and surgical management. Results of treated cases are discussed and analyzed periodically and can became part of publications.

After discharge, patients are planned an ad hoc follow up tailored on their clinical situation and necessities.