Metopic craniosynostosis, also called or metopic synostosis or trigonocephaly, is a disorder that occurs when the metopic suture, which is an opening in an infant's skull that runs from the top of the head through the forehead and down to the nose, closes prematurely. As a result, the skull and face become disorted, and the brain may fail to grow properly. Doctors treat metopic craniosynostosis with corrective surgery.
An infant with metopic craniosynostosis may have closely-spaced, bulging eyes and a narrow forehead. He or she might have a noticeable ridge running down the center of the forehead, or the forehead might have a distinct triangular shape. The baby might also be lacking a fontanel, or soft spot, in the top center of his of her skull.
As the child grows, the head might not grow in proportion to the rest of the body, and the back of his or her head may protrude outward as the brain grows. In severe cases, the pressure increases inside the skull, which can interfere with brain development. This might make the baby's physical appearance noticeably different from that of other children.
Since metopic craniosynostosis occurs more often in boys than in girls, researchers in 2011 believed that testosterone played a role in the premature closure of skull sutures. This condition may also be genetic, since it tends to occur within families across multiple generations. Fetuses that become constricted in one spot in the uterus can also develop craniosynostosis.
A doctor can diagnose metopic craniosynostosis by performing x-rays on the skull. He or she may also use magnetic resonance imaging (MRI) or computerized tomography (CT) scans to look at the sutures beneath the skin and muscles. Doctors might also perform a neurological exam.
Children who only have mild craniosynostosis do not necessarily require treatment. Boys or girls who have significant facial disorders or whose brains are not developing properly may require corrective surgery. The goal of surgery is to rebuild the skull so that it assumes a normal shape.
The surgery is usually most successful when it is performed on babies between the ages of four and ten months. In this process, a neurosurgeon and craniofacial surgeon work together to remove the entire skull and remodel the bones. Some doctors prefer a less invasive endoscopic procedure that involves removing a section of bone through a single incision in the forehead.
Most babies need to wear specialized headgear for as long as a year after the operation. The headgear is designed to mold the head into the desired shape after surgery. The doctor will want to see the baby regularly during that time period to make sure that the head is growing into a symmetrical and healthy shape.
