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Influence of metopic suture fusion associated with sagittal synostosis.
J Craniofac Surg. 2011 Jan; 22(1):77-83.JC

Abstract

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+Show Affiliations

Interdisciplinary Craniofacial Imaging Laboratory, Duke University Medical Center, Durham, North Carolina 27710, USA. jeffrey.marcus@duke.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21187774

Citation

Domeshek, Leahthan F., et al. "Influence of Metopic Suture Fusion Associated With Sagittal Synostosis." The Journal of Craniofacial Surgery, vol. 22, no. 1, 2011, pp. 77-83.
Domeshek LF, Das RR, Van Aalst JA, et al. Influence of metopic suture fusion associated with sagittal synostosis. J Craniofac Surg. 2011;22(1):77-83.
Domeshek, L. F., Das, R. R., Van Aalst, J. A., Mukundan, S., & Marcus, J. R. (2011). Influence of metopic suture fusion associated with sagittal synostosis. The Journal of Craniofacial Surgery, 22(1), 77-83. https://doi.org/10.1097/SCS.0b013e3181f6c56b
Domeshek LF, et al. Influence of Metopic Suture Fusion Associated With Sagittal Synostosis. J Craniofac Surg. 2011;22(1):77-83. PubMed PMID: 21187774.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of metopic suture fusion associated with sagittal synostosis. AU - Domeshek,Leahthan F, AU - Das,Rajesh R, AU - Van Aalst,John A, AU - Mukundan,Srinivasan,Jr AU - Marcus,Jeffrey R, PY - 2010/12/29/entrez PY - 2010/12/29/pubmed PY - 2011/6/3/medline SP - 77 EP - 83 JF - The Journal of craniofacial surgery JO - J Craniofac Surg VL - 22 IS - 1 N2 - 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. SN - 1536-3732 UR - https://www.unboundmedicine.com/medline/citation/21187774/Influence_of_metopic_suture_fusion_associated_with_sagittal_synostosis_ L2 - https://doi.org/10.1097/SCS.0b013e3181f6c56b DB - PRIME DP - Unbound Medicine ER -