Craniosynostosis is the premature closure of one or more cranial sutures. Treatment of craniosynostosis usually requires surgical intervention. Craniosynostosis restricts growth at the involved suture and causes excessive growth perpendicular to the fused suture. Early referral to a specialist is always recommended. There are different types of craniosynostosis, including: sagittal, coronal, metopic, and lambdoid. Infants diagnosed with craniosynostosis usually require surgery and should be referred immediately to a pediatric neurosurgeon or craniofacial specialist for further evaluation ad treatment. Early diagnosis is vital. Endoscopic surgeries are often recommended before three months of age.
Sagittal synostosis is the most common type of single suture craniosynostosis and results in a scaphocephalic head shape.
- Sagittal suture is usually ridged.
- Posterior cranial vault slopes inferiorly.
- Frontal and occipital bones have a pinched/boxy shape.
- The skull becomes progressively more abnormal and does not improve with repositioning.
Lambdoid Synostosis is the least common type of craniosynostosis and can be confused with plagiocephaly.
- Significant occipital asymmetry without anterior ear shift or frontal changes.
- Mastoid bossing on the side of occipital flattening.
- Contralateral parietal bossing.
Other types of synostosis include metopic, uni-coronal, bi-coronal, and synostoses that are manifested in syndromal disorders like Apert's and Crouzon's.
Deformational Plagiocephaly vs. Lambdoid Craniosynostosis
Deformational plagiocephaly can be difficult to differentiate from lambdoid craniosynostosis because both conditions present with asymmetry. The two deformities are shown below in the vertex view. Refer the infant to a specialist if the diagnosis is unclear.