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Published on: August 18, 2023
The changing epidemiologic spectrum of single-suture synostoses
Jesse Selber1, Russell R Reid, Chuma J Chike-Obi
1Philadelphia, Pa. From the Division of Plastic Surgery, the Division of Neurosurgery, and the Division of Genetics, University of Pennsylvania School of Medicine and The Children's Hospital of Philadelphia.
Metopic synostosis (a skull malformation) is increasing, challenging previous beliefs about its rarity. This rise may be linked to changing demographics and a higher proportion of syndromic cases.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Medical Demography
Background:
- Classic literature suggests metopic craniosynostosis is infrequent (3-10%) compared to other single-suture craniosynostosis.
- Recent observations indicate a potential shift in these long-established demographic patterns.
Purpose of the Study:
- To conduct a long-term demographic analysis of single-suture craniosynostosis incidence.
- To investigate trends in metopic synostosis compared to other single-suture types.
Main Methods:
- Retrospective chart review of single-suture synostosis cases treated between 1975-2004, excluding syndromic and multiple suture involvement.
- Statistical analysis including Chi square, Fisher's exact, and Moran's I for incidence and spatial distribution.
- Analysis of demographic factors such as maternal age and sex.
Main Results:
- A significant increase in metopic synostosis incidence was observed (p=0.011), outpacing sagittal and decreasing unicoronal synostosis.
- Geostatistical analysis showed increasing spatial separation of cases over time.
- Increased metopic maternal age (p=0.002, 0.0002) and a higher proportion of male and syndromic patients in the metopic group were noted from 1990-2004.
Conclusions:
- Metopic synostosis is demonstrably on the rise, contradicting historical data.
- Shifting demographic factors, including increased maternal age and a greater proportion of syndromic cases, may contribute to this epidemiological trend.
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