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Updated: May 16, 2026

Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Bregmatic wormian bone and metopic synostosis
Mitchell A Stotland1, Nicholas K Do, Thersia J Knapik
1Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. stotland@hitchcock.org
This study documents a rare case of metopic synostosis in an infant, incidentally discovering a large, pentagonal bregmatic wormian bone. Photographic evidence of this specific combination of cranial anomalies is unprecedented.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Anomalies
- Skeletal Dysplasias
Background:
- Metopic synostosis is a premature fusion of the metopic suture, affecting skull shape.
- Wormian bones, or ossicula wormiana, are supernumerary bones within cranial sutures.
- The co-occurrence of these findings is exceptionally rare.
Observation:
- A 14-week-old infant presented with metopic synostosis.
- An incidental large, pentagonal bregmatic wormian bone was identified.
- No prior photographic documentation exists for this specific combination.
Findings:
- The study details the incidence and etiology of supernumerary cranial bones.
- It reviews the significance of bregmatic wormian bones.
- The case highlights a unique presentation of metopic synostosis.
Implications:
- Contributes to the understanding of cranial suture development and anomalies.
- Provides a reference for rare craniofacial presentations in pediatric patients.
- Informs clinical evaluation and management of complex skull abnormalities.
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