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Updated: Aug 18, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Early development of infants with untreated metopic craniosynostosis
Seth Warschausky1, Jeff Angobaldo, Donald Kewman
1Craniofacial Anomalies Program, Department of Surgery, University of Michigan, Ann Arbor, Michigan 48108, USA. sethaw@umich.edu
Insights
Infants with metopic craniosynostosis showed average cognitive development, but some experienced language delays. Severity of the condition did not correlate with cognitive scores, contrary to expectations.
Area of Science:
- Pediatric Neurosurgery
- Developmental Pediatrics
- Craniofacial Surgery
Background:
- Craniosynostosis, a condition involving premature fusion of skull sutures, affects infant development.
- Perinatal risk factors and complications may influence outcomes in infants with craniosynostosis.
- Early cognitive development is a key concern for infants diagnosed with craniosynostosis.
Purpose of the Study:
- To investigate associations between craniosynostosis severity, perinatal factors, and early cognitive development in infants.
- To determine if developmental delays are more prevalent in infants with craniosynostosis compared to the general population.
- To explore specific developmental domains, including language and motor skills, in infants with metopic craniosynostosis.
Main Methods:
- Retrospective cross-sectional study of 22 infants diagnosed with metopic synostosis.
- Craniosynostosis severity assessed by neurosurgeons and confirmed radiographically.
- Cognitive status evaluated using the Bayley Scales of Infant Development, Second Edition.
Main Results:
- The average Mental Development Index score was within the normal range (96.0).
- No significant correlation was found between craniosynostosis severity and overall cognitive scores.
- A notable mean language quotient of 77.3 indicated potential language acquisition delays.
Conclusions:
- Increased severity of metopic craniosynostosis did not correlate with decreased cognitive or motor development.
- Infants with isolated metopic craniosynostosis may exhibit specific delays in language development.
- No significant links were identified between cognitive development and prenatal risk factors.
Background:
The purpose of this archival descriptive study was to examine the associations among craniosynostosis, perinatal risk factors or complications, and early cognitive development in infants diagnosed with craniosynostosis before they underwent surgery, to provide a greater empirical basis for surgical decision making and other early interventions. Specifically, it was hypothesized that there would be a greater number of infants with developmental delays than seen in the normative population. Furthermore, it was hypothesized that greater severity of synostosis would be correlated with lower cognitive and developmental scores. The secondary purpose of this study was to examine specific developmental domains such as language and motor skills in children with metopic craniosynostosis.
Methods:
The research subjects for this retrospective cross-sectional study were a consecutive series of 22 infants diagnosed with metopic synostosis: 86 percent male, ages 3.6 to 25.3 months (mean +/- SD, 10.6 +/- 6.4 months). Mean gestational age was 38.8 (2.3) months, mean birth weight was 107.7 ounces, and 48.1 percent subsequently had craniovault reconstruction. Severity of craniosynostosis was assessed by a plastic surgeon (Buchman) and a neurosurgeon (Muraszko) and was confirmed radiographically by an independent rater (Angobaldo). Cognitive status was assessed with the Bayley Scales of Infant Development, Second Edition, at a mean age 11.6 (4.8) months.
Results:
The mean Mental Development Index score for the sample was 96.0 (14.5), falling within the average range. Severity of synostosis was not significantly correlated with the overall Mental Development Index score. The mean language quotient for the sample was 77.3 (21.1).
Conclusions:
Despite suspicions that increased severity of deformity in infants with metopic craniosynostosis correlates with decreased cognitive and motor development, no such associations could be demonstrated. The results of this study did suggest, however, that children with isolated metopic craniosynostosis might show specific developmental delays in language acquisition. Finally, there were no significant correlations between cognitive development and prenatal risk factors.
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