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Morphologic Severity of Craniosynostosis: Implications for Speech and Neurodevelopment
Damini Tandon1, Gary B Skolnick1, Sybill D Naidoo1
1Division of Plastic and Reconstructive Surgery, Washington University in St. Louis, MO, USA.
Summary
Single-suture craniosynostosis (SSC) can impact development. This study found no link between skull shape severity and speech or psychological issues in sagittal or metopic SSC, but did find a link in unicoronal SSC.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Developmental Pediatrics
Background:
- Single-suture craniosynostosis (SSC) is a condition where one of the skull sutures fuses prematurely.
- SSC is associated with potential neurodevelopmental deficits, including speech-language and psychological concerns.
- Understanding the relationship between the severity of skull deformity and these concerns is crucial for patient management.
Purpose of the Study:
- To investigate the correlation between the morphologic severity of single-suture craniosynostosis (SSC) and the incidence of speech-language or psychological concerns.
- To differentiate these correlations based on the specific suture involved (sagittal, metopic, or unicoronal).
Main Methods:
- Sixty-two patients with SSC (33 sagittal, 17 metopic, 12 unicoronal) were analyzed.
- Morphologic severity was quantified using preoperative CT scans with specific metrics: adjusted cephalic index (aCI) for sagittal, interfrontal angle (IFA) for metopic, and anterior cranial fossa area ratio (ACFR) for unicoronal synostosis.
- Speech-language and psychological concerns were assessed at age ≥4.5 years, defined by recommendations for therapy or monitoring.
Main Results:
- Overall, 32% of patients had speech-language concerns and 44% had psychological concerns.
- No significant correlation was found between morphologic severity and speech-language or psychological concerns for patients with sagittal or metopic synostosis.
- A significant correlation was identified between increased morphologic severity (lower ACFR) and speech-language concerns in patients with unicoronal synostosis (ρ = .722, P = .008).
Conclusions:
- While a substantial proportion of patients with SSC experience speech-language or psychological concerns, the morphologic severity does not correlate with these issues in sagittal or metopic synostosis.
- Morphologic severity is significantly associated with speech concerns specifically in unicoronal synostosis, suggesting a potential link between skull shape and speech development in this subtype.
- These findings highlight the need for tailored neurodevelopmental assessments based on the type of single-suture craniosynostosis.
Keywords:
cephalometrycraniofacial morphologydysmorphologypsychological assessmentspeech disorderssynostosisMore Related Videos
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