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Updated: May 13, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
[Cranial development and growth following treatment of craniosynostosis skull deformities]
K W Grätz1, M C Locher, F R Carls
1Klinik und Poliklinik für Kiefer- und Gesichtschirurgie (Prof.Dr. Dr. med. Dr. h.c. mult. H. F. Sailer), Universitätsspital Zürich, Zürich, Deutschland.
Insights
Surgical vault correction for craniosynostosis does not impede calvaria growth. This study found no significant difference in cranial growth potential between syndromic and non-syndromic craniosynostosis cases post-operation.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Developmental Biology
Context:
- Craniosynostosis, the premature fusion of cranial sutures, affects skull development and may necessitate surgical intervention.
- Vault reconstruction is a common surgical approach for craniosynostosis, aiming to normalize intracranial volume and skull shape.
- Potential impacts of vault correction on ongoing calvarial growth require thorough investigation.
Purpose:
- To prospectively evaluate the surgical effect of vault correction on calvarial growth in children with craniosynostosis.
- To correlate pre- and post-operative growth percentiles of patients with normal growth percentiles.
- To compare calvarial growth outcomes between syndromic and non-syndromic craniosynostosis cases.
Summary:
- This prospective study analyzed 71 children undergoing vault correction for craniosynostosis, with 57 followed for over 12 months.
- Measurements of fronto-occipital circumference were compared to Prader's percentile table pre- and post-surgery.
- Results indicated no observed growth restriction of the reshaped calvaria, with similar growth potential noted in both syndromic and isolated craniosynostosis groups.
Impact:
- Surgical vault correction appears safe concerning calvarial growth in pediatric craniosynostosis.
- The findings suggest that surgical intervention does not negatively affect the natural growth trajectory of the skull.
- This research provides valuable data for surgical planning and patient counseling regarding long-term outcomes in craniosynostosis treatment.
Abstract:
Craniofacial development may be potentially implicated after vault corrections in cases of craniosynostosis. The aim of this prospective study was the investigation of the surgical effect on calvaria growth, correlating the percentiles of a group of patients before and after craniosynostosis correction in relation to the normal percentiles of growth. The patient population consisted of 71 children; the postoperative follow-up time in 57 patients was more than 12 months. Of the children followed up, 36 were male and 21 female. Thirty-six cases involved untreated non-syndromic craniosynostosis; the remaining 21 were syndrome cases. The patient ages ranged from 16 to 27 months. In 11 cases correction of an occipital craniosynostosis was carried out. The fronto-occipital circumference was registered in accordance with Prader's percentile table. The operative method included a fronto-parietal craniotomy, the temporary removal and shaping of the fronto-orbital band and a vault cranioplasty. During follow-up 13 patients treated with fronto-orbital advancement in cases of isolated craniosynostosis remained in the registered percentile curve. In 13 patients a change to a lower percentile curve was confirmed; 1 patient changed to a higher curve. In cases of syndromic craniosynostosis 10 patients remained in the post-operatively registered percentile curve; 8 patients changed to a lower and 1 patient to a higher percentile curve. No growth restriction of the reshaped calvaria after surgical correction of craniosynostosis was observed. No significant difference was found in the potential calvaria growth between syndromic and isolated craniosynostosis.
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