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Cranial deformation in craniosynostosis. A new explanation
J B Delashaw1, J A Persing, J A Jane
1Department of Neurosurgery, University of Florida, Gainesville.
Neurosurgery Clinics of North America
|July 1, 1991
Summary
Premature fusion of cranial sutures (craniosynostosis) restricts skull growth perpendicularly. Compensatory bone deposition at adjacent sutures explains resulting deformities, though human studies are needed.
Area of Science:
- Craniofacial development
- Pediatric neurosurgery
- Developmental biology
Background:
- Virchow (1851) described restricted skull growth perpendicular to fused sutures.
- Previous work did not predict compensatory growth patterns in craniosynostosis syndromes.
- Deformities arise from premature fusion of cranial vault sutures.
Purpose of the Study:
- To explain deformities resulting from premature closure of coronal, sagittal, metopic, or lambdoid sutures.
- To propose four rules predicting compensatory growth patterns.
- To investigate the underlying mechanisms of craniosynostosis.
Main Methods:
- Analysis of clinical deformities in various craniosynostosis forms.
- Examination of existing animal studies on asymmetrical bone deposition in sutures.
- Formulation of predictive rules based on observed growth patterns.
Main Results:
- Four rules derived to predict deformities: fused sutures act as a single plate, asymmetrical deposition occurs at perimeter sutures, adjacent sutures compensate more, and non-perimeter sutures show enhanced deposition.
- These rules assume sutures can deposit bone asymmetrically.
- Animal studies support unequal growth patterns, but human studies are lacking.
Conclusions:
- The four rules provide a framework for understanding craniosynostosis deformities.
- Further human studies are needed to validate asymmetrical bone deposition in response to stenotic sutures.
- The applicability of these rules to cranial base abnormalities remains unclear.