Related Experiment Video
Updated: Mar 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
Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly
Rosalinda Calandrelli1, Gabriella D'Apolito2, Luca Massimi3
1Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy. rocalan1@virgilio.it.
Insights
Early closure of the unicoronal suture, not skull base sutures, is linked to craniofacial asymmetry in children with anterior plagiocephaly. This finding impacts understanding of anterior synostotic plagiocephaly development.
Area of Science:
- Craniofacial surgery
- Pediatric neurosurgery
- Plastic surgery
Background:
- Anterior plagiocephaly involves premature fusion of cranial sutures.
- Understanding the role of different sutures in craniofacial development is crucial.
Purpose of the Study:
- To investigate the relationship between premature synostosis of coronal and splanchnocranium sutures and craniofacial dysmorphology in anterior plagiocephaly.
- To differentiate the impact of major (unicoronal) versus minor sutures on skull base and facial development.
Main Methods:
- Quantitative analysis of skull base and facial changes using high-resolution CT scans.
- Comparison of 18 children with anterior synostotic plagiocephaly against 18 healthy controls.
Main Results:
- All patients had patent splanchnocranium sutures.
- Fifteen of 18 patients had isolated unicoronal suture synostosis, correlating with anterior synostotic plagiocephaly groups II and III.
- Unilateral coronal suture fusion led to significant asymmetry in anterior and middle fossae, and secondary facial complex asymmetry.
Conclusions:
- Skull base suture involvement is not the primary cause of skull base changes and facial asymmetry in anterior synostotic plagiocephaly.
- The timing of unilateral coronal suture closure is likely the main determinant of craniofacial dysmorphology severity.
Purpose:
The study aimed to identify premature synostosis of "major" and "minor" sutures of the coronal sutural arch and splanchnocranium sutures to evaluate the relationship between craniofacial dysmorphology and the sutural pattern in children with anterior plagiocephaly.
Methods:
A quantitative analysis of the skull base and facial changes was performed on preoperative high-resolution CT images in 18 children with anterior synostotic plagiocephaly and compared with imaging findings in 18 age-matched healthy subjects.
Results:
All patients had patent splanchnocranium sutures. Fifteen out of 18 children showed early and isolated synostosis of the unicoronal suture (the major suture of the coronal ring) and were classified in groups II and III according to the classification scheme of anterior synostotic plagiocephaly based on the severity of craniofacial dysmorphology. Premature fusion of the unilateral coronal suture in groups II and III caused a marked asymmetry and reduced growth of the anterior and middle fossae on the synostotic side and a secondary varying severity in terms of asymmetric growth of the facial complex. Although both groups showed anterior displacement of the mandibular articulation on the synostotic side, group II showed only maxillary asymmetry, while group III showed maxillary and mandibular asymmetry.
Conclusions:
In anterior synostotic plagiocephaly, the severity of skull base changes and asymmetric growth of the facial complex is not caused by skull base sutural synostotic involvement but is probably related to the different timing of unilateral coronal suture closure.
Related Concept Videos
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:14Cranial Bones: Superior and Posterior View
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...