Mendosal suture patency beyond infancy: a large-scale computed tomography study in an Asian cohort

Area of Science:

• Craniology
• Anatomical Variations
• Pediatric Radiology

Background:

• The mendosal suture (accessory occipital suture) typically obliterates early in life.
• Its persistence is often misdiagnosed as a skull fracture.
• Prevalence in Asian populations is not well-established.

Purpose of the Study:

• Determine the prevalence and characteristics of persistent mendosal sutures.
• Investigate their occurrence in a Thai population aged 1-20 years.
• Clarify their clinical significance.

Main Methods:

• Retrospective review of 1403 cranial CT scans.
• Three-dimensional reconstructions evaluated by blinded investigators.
• Sutures classified as completely or partially patent; reliability assessed.

Main Results:

• Overall prevalence of persistent mendosal sutures was 6.4% (partial 4.8%, complete 1.6%).
• Observed across all age groups (1-20 years).
• No significant association with sex, family history, or other synostoses; normal cephalic indices.

Conclusions:

• The mendosal suture persists into adulthood in 6.4% of Thais.
• Challenges the notion of consistent early obliteration.
• Considered a benign anatomical variant, not a marker of disease.