A Surgical Technique for Management of the Metopic Suture in Syndromic Craniosynostosis

J Craniofac Surg. 2017 May;28(3):675-678. doi: 10.1097/SCS.0000000000003459.

Abstract

Objectives: The objective is to describe a new surgical procedure developed in the San Jose Pediatric University Hospital for the management of syndromic synostosis of the metopic suture in a patient clinically diagnosed with Saethre-Chotzen syndrome.

Methods: The diagnosis of Saethre-Chotzen syndrome, bilateral coronal sutures, and metopic suture synostoses was made through photographic, anthropometric, exophthalmometric, and computed tomography analysis. The keel-like frontal bone deformity was corrected following resection using a fusiform osteotomy, remodelling was obtained by milling the edges, and the bony fragments were repositioned and fixed on the posterior wall of the frontal bone. Additionally, a fronto-orbital advancement with a self-stabilizing bar was performed.

Results: The 1-year postoperative results showed improvement in the position of the fronto-orbital bar, adequate cranial expansion, satisfactory correction of the upper facial third alteration, and correction of the keel-like deformity.

Conclusions: The surgical approach has not previously been described in the literature and offers an alternative management for syndromic craniosyntostosis of the metopic suture, avoiding skull irregularities.

Publication types

  • Case Reports
  • Historical Article

MeSH terms

  • Acrocephalosyndactylia / diagnosis
  • Acrocephalosyndactylia / surgery*
  • Cranial Sutures / surgery
  • Craniosynostoses / diagnosis
  • Craniosynostoses / genetics
  • Craniosynostoses / surgery*
  • Female
  • Follow-Up Studies
  • Frontal Bone / abnormalities
  • Frontal Bone / surgery
  • History, Ancient
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature, Diseases / diagnosis
  • Infant, Premature, Diseases / surgery
  • Osteotomy / methods
  • Phenotype
  • Syndrome
  • Tomography, X-Ray Computed