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Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment
Jonathan Lee1, Sanjay Naran2,3,4, Daniel Mazzaferro5
1From the Division of Plastic and Reconstructive Surgery, Baystate Health System, Springfield, Mass.
Plastic and Reconstructive Surgery. Global Open
|June 26, 2023
Summary
Unilateral lambdoid craniosynostosis presents distinct facial features, including an elevated ipsilateral ear and contralateral parietal bossing. These frontofacial characteristics aid in differentiating it from deformational plagiocephaly.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Plastic Surgery
Background:
- Unilateral lambdoid craniosynostosis (ULC) is a complex condition often confused with deformational plagiocephaly.
- Diagnosis typically relies on cranial imaging and posterior/bird's-eye views, but frontofacial characteristics are less understood.
- Facial assessment offers a potentially simpler diagnostic approach due to reduced obstruction.
Purpose of the Study:
- To describe the characteristic frontofacial morphology of nonsyndromic unilateral lambdoid craniosynostosis.
- To identify key diagnostic features visible on preoperative photographs.
Main Methods:
- Retrospective cohort review of patients with isolated ULC.
- Analysis of preoperative frontal and profile photographs for salient facial characteristics.
Main Results:
- Nineteen nonsyndromic patients (11 left, 8 right ULC) were analyzed.
- Key findings included greater ipsilateral ear visibility, contralateral parietal bossing, and mild contralateral frontal bossing.
- Patients exhibited tall orbits, varying turricephaly, and C-shaped facial scoliosis with contralateral deviation of the nasal root and chin.
Conclusions:
- Hallmark frontofacial features of ULC include ipsilateral ear visibility, contralateral parietal bossing, and ipsilateral facial scoliosis.
- These features, potentially linked to mastoid bulge displacement, aid in diagnosis.
- Further research is needed to evaluate the long-term correction of these facial features post-surgery.
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