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The 27 Facial Sutures: Timing and Clinical Consequences of Closure
Maxwell M Wang1, Christos S Haveles1, Brian K Zukotynski1
1From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine; and Section of Plastic and Reconstructive Surgery, University of Chicago.
Insights
Facial sutures are vital for facial growth and shape, but their role in craniofacial diseases is overlooked. Premature closure of these sutures can cause significant facial deformities and may be implicated in complex conditions.
Area of Science:
- Craniofacial biology
- Developmental biology
- Surgical anatomy
Background:
- Facial sutures are crucial for postnatal facial development, mediating bone growth and refining facial structure.
- Despite their importance, facial sutures receive less research attention compared to calvarial sutures.
- Premature closure of facial sutures disrupts normal growth patterns, leading to dysmorphologies.
Purpose of the Study:
- To comprehensively review the physiology and development of 27 key facial sutures.
- To elucidate the contribution of facial sutures to postnatal facial development.
- To explore the clinical consequences of premature facial suture closure.
Main Methods:
- Systematic review of existing literature on facial suture development and pathology.
- Analysis of the role of facial sutures in craniofacial growth and morphology.
- Correlation of suture abnormalities with craniofacial diseases.
Main Results:
- Facial sutures are essential for growth, stress absorption, and maintaining facial structure into adolescence.
- Abnormalities in individual sutures lead to localized deformities.
- Generalized suture abnormalities may contribute to complex craniofacial syndromes.
Conclusions:
- Facial sutures play a significant, yet underappreciated, role in craniofacial development and disease.
- Understanding facial suture physiology is critical for diagnosing and treating craniofacial abnormalities.
- Further research into facial sutures may reveal new insights into conditions like syndromic craniosynostosis.
Summary:
Facial sutures contribute significantly to postnatal facial development, but their potential role in craniofacial disease is understudied. Since interest in their development and physiology peaked in the mid-twentieth century, facial sutures have not garnered nearly the same clinical research interest as calvarial sutures or cranial base endochondral articulations. In addition to reinforcing the complex structure of the facial skeleton, facial sutures absorb mechanical stress and generally remain patent into and beyond adolescence, as they mediate growth and refine the shape of facial bones. However, premature closure of these sites of postnatal osteogenesis leads to disrupted growth vectors and consequent dysmorphologies. Although abnormality in individual sutures results in isolated facial deformities, we posit that generalized abnormality across multiple sutures may be involved in complex craniofacial conditions such as syndromic craniosynostosis. In this work, the authors comprehensively review 27 key facial sutures, including physiologic maturation and closure, contributions to postnatal facial development, and clinical consequences of premature closure.
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