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Metopic synostosis: Defining the temporal sequence of normal suture fusion and differentiating it from synostosis on the basis of computed tomography images.
Plast Reconstr Surg. 2003 Oct; 112(5):1211-8.PR

Abstract

Only the metopic suture normally fuses during early childhood; all other cranial sutures normally fuse much later in life. Despite this, metopic synostosis is one of the least common forms of craniosynostosis. The temporal sequence of normal physiologic metopic suture fusion remains undefined and controversial. Therefore, diagnosis of metopic synostosis on the basis of computed tomography images alone can prove misleading. The present study sought to determine the normal sequence of metopic suture fusion and characterize both endocranial and ectocranial suture morphology. An analysis of computed tomography scans of 76 trauma patients, ranging in age from 10 days to 18 months, provided normative craniofacial data that could be compared to similar data obtained from the preoperative computed tomography scans of 30 patients who had undergone surgical treatment for metopic synostosis. Metopic suture fusion was complete by 6 to 8 months in all nonsynostotic patients, with initiation of suture fusion evident as early as 3 months of age. Fusion was found to commence at the nasion, proceed superiorly in progressive fashion, and conclude at the anterior fontanelle. Although an endocranial ridge was not commonly seen in synostotic patients, an endocranial metopic notch was virtually diagnostic of premature suture fusion and was seen in 93 percent of synostotic patients. A metopic notch was not seen in any nonsynostotic patient. The morphologic and normative craniofacial data presented permit diagnosis of metopic synostosis based on computed tomography images obtained beyond the normal fusion period.

Authors+Show Affiliations

Division of Plastic Surgery, University of Pennsylvania Medical Center, Children's Hospital of Philadelphia, 19104, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14504503

Citation

Weinzweig, Jeffrey, et al. "Metopic Synostosis: Defining the Temporal Sequence of Normal Suture Fusion and Differentiating It From Synostosis On the Basis of Computed Tomography Images." Plastic and Reconstructive Surgery, vol. 112, no. 5, 2003, pp. 1211-8.
Weinzweig J, Kirschner RE, Farley A, et al. Metopic synostosis: Defining the temporal sequence of normal suture fusion and differentiating it from synostosis on the basis of computed tomography images. Plast Reconstr Surg. 2003;112(5):1211-8.
Weinzweig, J., Kirschner, R. E., Farley, A., Reiss, P., Hunter, J., Whitaker, L. A., & Bartlett, S. P. (2003). Metopic synostosis: Defining the temporal sequence of normal suture fusion and differentiating it from synostosis on the basis of computed tomography images. Plastic and Reconstructive Surgery, 112(5), 1211-8.
Weinzweig J, et al. Metopic Synostosis: Defining the Temporal Sequence of Normal Suture Fusion and Differentiating It From Synostosis On the Basis of Computed Tomography Images. Plast Reconstr Surg. 2003;112(5):1211-8. PubMed PMID: 14504503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metopic synostosis: Defining the temporal sequence of normal suture fusion and differentiating it from synostosis on the basis of computed tomography images. AU - Weinzweig,Jeffrey, AU - Kirschner,Richard E, AU - Farley,Alexander, AU - Reiss,Philip, AU - Hunter,Jill, AU - Whitaker,Linton A, AU - Bartlett,Scott P, PY - 2003/9/25/pubmed PY - 2003/10/22/medline PY - 2003/9/25/entrez SP - 1211 EP - 8 JF - Plastic and reconstructive surgery JO - Plast Reconstr Surg VL - 112 IS - 5 N2 - Only the metopic suture normally fuses during early childhood; all other cranial sutures normally fuse much later in life. Despite this, metopic synostosis is one of the least common forms of craniosynostosis. The temporal sequence of normal physiologic metopic suture fusion remains undefined and controversial. Therefore, diagnosis of metopic synostosis on the basis of computed tomography images alone can prove misleading. The present study sought to determine the normal sequence of metopic suture fusion and characterize both endocranial and ectocranial suture morphology. An analysis of computed tomography scans of 76 trauma patients, ranging in age from 10 days to 18 months, provided normative craniofacial data that could be compared to similar data obtained from the preoperative computed tomography scans of 30 patients who had undergone surgical treatment for metopic synostosis. Metopic suture fusion was complete by 6 to 8 months in all nonsynostotic patients, with initiation of suture fusion evident as early as 3 months of age. Fusion was found to commence at the nasion, proceed superiorly in progressive fashion, and conclude at the anterior fontanelle. Although an endocranial ridge was not commonly seen in synostotic patients, an endocranial metopic notch was virtually diagnostic of premature suture fusion and was seen in 93 percent of synostotic patients. A metopic notch was not seen in any nonsynostotic patient. The morphologic and normative craniofacial data presented permit diagnosis of metopic synostosis based on computed tomography images obtained beyond the normal fusion period. SN - 0032-1052 UR - https://www.unboundmedicine.com/medline/citation/14504503/Metopic_synostosis:_Defining_the_temporal_sequence_of_normal_suture_fusion_and_differentiating_it_from_synostosis_on_the_basis_of_computed_tomography_images_ L2 - https://doi.org/10.1097/01.PRS.0000080729.28749.A3 DB - PRIME DP - Unbound Medicine ER -