Correction of Metopic Synostosis Utilizing an In Situ Bandeau Approach

Abstract

Metopic craniosynostosis is a common growth disturbance in the infant cranium, second only to sagittal synostosis. Presenting symptoms are usually of a clinical nature and are defined by an angular forehead, retruded lateral brow, bitemporal narrowing, and a broad-based occiput. These changes create the pathognomonic trigonocephalic cranial shape. Aesthetic in nature, these morphological changes do not constitute the only developmental issues faced by children who present with this malady. Recent studies and anecdotal evidence have also demonstrated that children who present with metopic synostosis may face issues with respect to intellectual and/or psychological development. The authors present an elegant approach to the surgical reconstruction of the trigonocephalic cranium using an in situ bandeau approach.

Keywords

craniosynostosis - metopic - trigonocephaly - suture

• References

• 1 Kweldam CF, van der Vlugt JJ, van der Meulen JJ. The incidence of craniosynostosis in the Netherlands, 1997-2007. J Plast Reconstr Aesthet Surg 2011; 64 (5) 583-588
• 2 van der Meulen J. Metopic synostosis. Childs Nerv Syst 2012; 28 (9) 1359-1367
• 3 Anderson FM. Treatment of coronal and metopic synostosis: 107 cases. Neurosurgery 1981; 8 (2) 143-149
• 4 Shillito Jr J, Matson DD. Craniosynostosis: a review of 519 surgical patients. Pediatrics 1968; 41 (4) 829-853
• 5 Collmann H, Sörensen N, Krauss J. Consensus: trigonocephaly. Childs Nerv Syst 1996; 12 (11) 664-668
• 6 McCarthy JG, Epstein F, Sadove M, Grayson B, Zide B. Early surgery for craniofacial synostosis: an 8-year experience. Plast Reconstr Surg 1984; 73 (4) 521-533
• 7 Nellhaus G. Head circumference from birth to eighteen years. Practical composite international and interracial graphs. Pediatrics 1968; 41 (1) 106-114
• 8 Vu HL, Panchal J, Parker EE, Levine NS, Francel P. The timing of physiologic closure of the metopic suture: a review of 159 patients using reconstructed 3D CT scans of the craniofacial region. J Craniofac Surg 2001; 12 (6) 527-532
• 9 Oi S, Matsumoto S. Trigonocephaly (metopic synostosis). Clinical, surgical and anatomical concepts. Childs Nerv Syst 1987; 3 (5) 259-265
• 10 Tessier P. [Total facial osteotomy. Crouzon's syndrome, Apert's syndrome: oxycephaly, scaphocephaly, turricephaly]. Ann Chir Plast 1967; 12: 273-286
• 11 Tessier P, Guiot G, Rougerie J, Delbet JP, Pastoriza J. Ostéotomies cranio-naso-orbito-faciales. Hypertélorisme. Ann Chir Plast 1967; 12 (2) 103-118
• 12 Marchac D. Radical forehead remodeling for craniostenosis. Plast Reconstr Surg 1978; 61 (6) 823-835
• 13 Salyer KE. Personal contributions to craniofacial surgery. Scand J Plast Reconstr Surg Hand Surg Suppl 1995; 27: 19-47
• 14 Whitaker LA, Bartlett SP, Schut L, Bruce D. Craniosynostosis: an analysis of the timing, treatment, and complications in 164 consecutive patients. Plast Reconstr Surg 1987; 80 (2) 195-212
• 15 Vicari FA, Zukowski M, Endoscopic assisted craniofacial surgery. In Marchac D. , ed. Craniofacial Surgery 6. Proceedings of the Sixth Inter- national Congress of the International Society of Craniofacial Surgery. Monduzzi Editore: Bologna, Italy; 1995: 77-81
• 16 Jimenez DF, Barone CM. Endoscopic craniectomy for early surgical correction of sagittal craniosynostosis. J Neurosurg 1998; 88 (1) 77-81
• 17 Barone CM, Jimenez DF. Endoscopic craniectomy for early correction of craniosynostosis. Plast Reconstr Surg 1999; 104 (7) 1965-1973 , discussion 1974–1975
• 18 Hendel PM, Nadell JM. Projection geometry and stress-reduction techniques in craniofacial surgery. Plast Reconstr Surg 1989; 83 (2) 217-227