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Influence of metopic suture fusion associated with sagittal synostosis.
MedLine Citation:
PMID:  21187774     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Some patients with sagittal synostosis present with a fused metopic suture. We hypothesize that premature metopic suture fusion consistently and identifiably alters form associated with sagittal synostosis. We previously validated three-dimensional vector analysis as a tool for the study of cranial morphology and used it herein to distinguish between dysmorphologies of isolated sagittal synostosis (ISS) and combined sagittal-metopic synostosis (CSM).Preoperative computed tomographic scans for patients with ISS and CSM were compared with matched normative counterparts. Premature metopic suture fusion was defined by established radiographic criteria. Color-coded point clouds were created for each scan, with color gradient based on patient deviation from normal across the dysmorphic skull. Standard deviation data were evaluated in 7 cranial regions and compared between ISS and CSM. Mean ISS and CSM point clouds were evaluated. Using three-dimensional vector analysis, standard anthropometric data/indices were determined and compared between the 2 groups.Differences in ISS and CSM regional deviations and index measurements were not statistically significant. Mean ISS and CSM representations depicted similar overall morphology.Using accepted criteria for identification of metopic synostosis in CSM, only subtle differences appear between the 2 populations on average. Expected morphologic changes associated with metopic synostosis are present in only a small number of patients with CSM, arguing against our hypothesis, and calling into question the criteria used to identify premature metopic suture fusion. Normal metopic suture fusion occurs for a continuum of time. Our findings suggest that the normal continuum may begin earlier than the literature suggests. In the setting of sagittal synostosis, the influence of metopic suture fusion and treatment is best determined by individual morphologic analysis.
Authors:
Leahthan F Domeshek; Rajesh R Das; John A Van Aalst; Srinivasan Mukundan; Jeffrey R Marcus
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  22     ISSN:  1536-3732     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-83     Citation Subset:  D    
Affiliation:
From the *Interdisciplinary Craniofacial Imaging Laboratory, Duke University Medical Center, Durham, North Carolina; †Department of Biomedical Engineering, Duke University, Durham, North Carolina; ‡Division of Plastic Surgery, University of North Carolina, Chapel Hill, North Carolina; §Department of Radiology, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts; and ∥Division of Plastic Surgery, Duke University Medical Center, Durham, North Carolina.
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