Abstract
The decision about which metopic synostosis patients should undergo surgery remains
controversial. Multiple measures for radiographic severity have been developed in
order to determine the optimal criteria for treatment. The aim of this study was to
perform an extensive craniomorphometric analysis of patients who underwent surgery
for metopic synostosis to validate and compare the various severity scales developed
for this non-syndromic craniosynostosis. A comparative morphometric analysis was performed
using computed tomography scans of preoperative metopic synostosis patients (n = 167) and normal controls (n = 44). Measurements included previous and newly developed metopic severity indices.
Volumetric and area analyses were used to determine the degree of anterior cranial
area and potential volume restrictions. Of the severity indices measured, the frontal
angle, endocranial bifrontal angle (EBF), adjusted EBF (aEBF), anterior cranial fossa
angle, horizontal cone angle, and bitemporal/biparietal distance ratio were significantly
different in the metopic subjects relative to controls overall. However, metopic index,
orbital rim angle, foramen ovale distance, and cranial volume exhibited no significant
difference from controls. Only the frontal angle and aEBF correlated with the changes
in anterior cranial dimensions observed in metopic synostosis. In conclusion, the
frontal angle and aEBF provide the most accurate measures of severity in metopic synostosis.
Key words
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Article info
Publication history
Published online: January 19, 2021
Accepted:
November 27,
2020
Identification
Copyright
© 2020 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
