Treatment of coronal and metopic synostosis: 107 cases

This paper presents a personal series of 107 children with synostosis, 53 unicoronal, 27 bicoronal, and 28 metopic cases (1 child had both metopic and bicoronal synostosis). In 16 patients, other vault sutures later closed partially, some requiring operation. All of the patients underwent surgical treatment without mortality or notable morbidity. Nineteen patients showed mild or moderate mental retardation; other defects included cleft palate, epicanthic folds, strabismus, and syndactyly. Three patients with unicoronal closure had a second operation about 5 years after the initial craniectomy, and 2 required a third procedure. Cranioplasty was done in 10 patients for persisting skull defects. The recent results have been satisfactory in most cases, probably because of more precise diagnosis and improved surgical techniques. It is concluded that craniofacial operations for synostosis should be as extensive as necessary, and if subsequent revision or cranioplasty is appropriate it should be done.