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Updated: Aug 23, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Craniosynostosis
Haidar Kabbani1, Talkad S Raghuveer
1University of Kansas Medical Center, Kansas City, Kansas 66105, USA.
Insights
Differentiating infant skull deformities like deformational plagiocephaly from craniosynostosis is crucial. Physical examination can distinguish these conditions, preventing delayed treatment for serious craniosynostosis.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Developmental Pediatrics
Background:
- Skull deformities in infants present diagnostic and therapeutic challenges.
- Deformational plagiocephaly is common and benign, but must be differentiated from craniosynostosis, a more serious condition.
- Craniosynostosis can occur in isolation or as part of a syndrome.
Purpose of the Study:
- To outline key clinical distinctions between deformational plagiocephaly and craniosynostosis in infants.
- To emphasize the importance of early diagnosis and evaluation for infant skull deformities.
Main Methods:
- Clinical examination of infant head shape, including assessment of posterior and frontal bossing.
- Evaluation of ear position relative to the skull.
- Review of diagnostic modalities for craniosynostosis: physical exam, radiography, and CT scans.
Main Results:
- Lambdoid synostosis shows posterior parietal bossing contralateral to the flat area and posterior ear displacement.
- Deformational plagiocephaly presents with frontal bossing ipsilateral to the flat area and anterior ear displacement.
- Craniosynostosis, if untreated, can impede brain growth and increase intracranial pressure.
Conclusions:
- Physical examination provides critical clues to differentiate deformational plagiocephaly from craniosynostosis.
- Early diagnosis and evaluation of infant skull deformities are essential to prevent adverse outcomes associated with craniosynostosis.
Abstract:
Skull deformity in infants continues to be a diagnostic and therapeutic challenge. Deformational plagiocephaly is a common and somewhat benign cause of skull deformity in infants that must be distinguished from the more serious craniosynostosis, which occurs alone or as a syndrome. Examining an infant's head from above can help the physician distinguish true lambdoid synostosis from deformational plagiocephaly. In infants with lambdoid synostosis, the posterior bossing is in the parietal area contralateral to the flat part of the head. Deformational plagiocephaly causes frontal bossing ipsilateral to the flat part of the head. In infants with lambdoid synostosis, the ear is displaced posteriorly toward the fused suture. In infants with deformational plagiocephaly, the ear is displaced anteriorly. Isolated sagittal synostosis is the most common type of craniosynostosis. Of the more than 150 craniosynostosis syndromes, Crouzon's disease and Apert's syndrome account for the majority of cases. The diagnosis of craniosynostosis relies on physical examination, plain radiography, and computed tomography. Untreated progressive craniosynostosis leads to inhibition of brain growth, and an increase in intracranial and intraorbital pressure. Infants should be evaluated as soon as they are diagnosed.
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