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Updated: Apr 29, 2026
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Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
446
Three-dimensional orbital dysmorphology in metopic synostosis
Harib H Ezaldein1, Philipp Metzler1, John A Persing1
1Department of Plastic and Reconstructive Surgery, Yale University School of Medicine, 330 Cedar St, BB 3rd Floor, New Haven, CT 06520, USA.
Summary
Orbital dysmorphology in metopic synostosis, characterized by trigonocephaly, worsens with severity. Corneal projection and orbital depth are key indicators, suggesting lateral orbital wall expansion is crucial for treatment.
Area of Science:
- Craniofacial surgery
- Pediatric neurosurgery
- Ophthalmology
Background:
- Metopic synostosis involves premature fusion of the metopic suture, leading to trigonocephaly.
- Phenotypic evaluations often overlook orbital characteristics, focusing primarily on forehead morphology.
- Understanding orbital dysmorphology is crucial for comprehensive management of metopic synostosis.
Purpose of the Study:
- To investigate orbital dysmorphology in patients with metopic synostosis compared to controls.
- To analyze the correlation between the degree of trigonocephaly and orbital structural changes.
- To identify specific orbital parameters affected by metopic synostosis.
Main Methods:
- Comparative analysis of CT scans from metopic and control groups.
- Quantification of orbital parameters including plane angle, width, depth, volume, and corneal projection.
- Classification of trigonocephaly into moderate and severe based on endocranial bifrontal angle.
Main Results:
- Significant differences in orbital plane angle, depth, and corneal projection between metopic and control groups.
- Orbital height was reduced in severe metopic synostosis cases.
- Corneal projection showed a strong correlation with the severity of trigonocephaly.
Conclusions:
- Orbital dysmorphology is directly related to the degree of trigonocephaly in metopic synostosis.
- Functional defects, such as exorbitism, are associated with worsening trigonocephaly.
- Surgical correction should prioritize expansion and advancement of the lateral orbital wall.
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