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Updated: Jun 25, 2026

Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Fluctuating asymmetry and developmental instability in sagittal craniosynostosis
Valerie Burke Deleon1, Joan T Richtsmeier
1John Hopkins University, Baltimore, MD, USA. vdeleon@jhmi.edu
Nonsyndromic sagittal craniosynostosis is not linked to widespread developmental instability. However, localized skull asymmetry in affected children may relate to dura mater attachments.
Area of Science:
- Craniofacial Surgery
- Developmental Biology
- Pediatric Neurosurgery
Background:
- Premature fusion of skull sutures, known as craniosynostosis, can impact cranial development.
- Sagittal craniosynostosis, the premature fusion of the sagittal suture, is the most common form.
- Developmental instability, indicated by fluctuating asymmetry, is a potential factor in craniofacial anomalies.
Purpose of the Study:
- To investigate the association between nonsyndromic sagittal craniosynostosis and developmental instability.
- To analyze fluctuating asymmetry in skull shape in children with sagittal craniosynostosis compared to controls.
Main Methods:
- Cranial shape analysis using landmark data from 3D CT reconstructions.
- Application of Euclidean distance matrix analysis (EDMA) to quantify fluctuating asymmetry.
- Comparison of asymmetry levels between 22 children with sagittal craniosynostosis and 22 controls.
Main Results:
- No statistically significant overall increase in fluctuating asymmetry was observed in the craniosynostosis group.
- Localized increases in fluctuating asymmetry were found at the pterion and anterior clinoid processes.
- A significant correlation in fluctuating asymmetry values was noted between the craniosynostosis and control groups.
Conclusions:
- System-wide developmental instability is unlikely to be the primary cause of nonsyndromic sagittal craniosynostosis.
- Localized asymmetry at the anterior clinoid processes may be associated with dural attachments.
- Further research is needed to explore the specific mechanisms underlying localized cranial asymmetry.
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