Craniofacial admission criteria

This is a list of patient diagnoses which are admitted to Great Ormond Street Hospital (GOSH) by our Craniofacial team, the timeframe in which they should be treated and their estimated length of stay (LoS). 

Health professionals are reminded that this information is for guidance only.

Emergency admissions

Children with the following diagnoses are considered an emergency and should be transferred to GOSH within hours from receipt of referral.
 Diagnosis  Estimated LoS
 Blocked shunt  2 days
 Infected shunt  10-14 days

Urgent admissions

Estimated LoS
Acute hydrocephalus 3-5 days
Craniofacial embolisations 1-2 days
Craniofacial tumours (benign and malignant) 4-7 days
Newly diagnosed baby with Pfeiffers/Apert/Crouzon 7-14 days
Posterior vault expansion with springs - for raised intracranial pressure 4 days
Children with the following diagnoses should be transferred to GOSH within days from receipt of referral.

Elective admissions

Estimated LoS
AP shortening for sagittal synostosis - before 6 months of age
Overnight stay
Bilateral lower eyelid wolfe graft reconstruction
3 days
Burring of forehead
3 days
Correction of sagittal synostosis with springs - before 4 months of age
Overnight stay 
Excision of dermoid cyst with intracranial extension
3-4 days
Frontal orbital remodelling
4 days
Major midfacial surgery i.e. box osteotomies/monobloc/bipartition withour red frame 7-10 days
Monobloc/Facial bipartition distraction with red frame
10-14 days
Orbital wall reconstruction 4 days
Removal of red frame
Removal of sagittal springs
Sleep study for child < 6 months of age or with an airway 1 day
Total Calvarial remodelling
4 days
Children with the following diagnoses should be referred to GOSH via the non-emergency pathway.
Reviewed by: David Dunaway (Consultant Plastic Surgeon) and Andrea White (Clinical Nurse Specialist), February 2012