Isolated (Non-Syndromic) Craniosynostosis: Metopic Synostosis
Metopic craniosynostosis is more common than previously recognized. Approximately 20-25 percent of craniosynostosis cases involve the metopic suture. The head shape that results from the closure of this suture is called trigonocephaly, because of the triangular shape of the skull with an abnormally pointed, narrow forehead and wide, flat back of the skull.
The severity of head shape and appearance changes in metopic craniosynostosis ranges from thickening of the suture, causing a ridge in an otherwise normal skull, to the most severe, with a severely pointed forehead. The most severe have:
• A narrow forehead with a noticeable ridge in the midline
• Eyes that are too close to each other, with eyelid folds that cover the inside corners of the eyes (epicanthal folds)
Metopic craniosynostosis can be treated with either strip craniectomy with use of molding helmet after surgery or fronto-orbital advancement, depending on the deformity. The goal of treatment is to restore a normal contour to the forehead and upper portion of the eye sockets.