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Metopic synostosis

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  • the metopic suture runs down the midline of the forehead
    • if there is premature fusion of this suture (metopic synostosis) then this results in a triangular shaped forehead called trigonocephaly
      • in metopic synostosis, a bony ridge is generally palpable - this extends from the bridge of the nose to the upper part of the forehead
        • premature fusion results in a prominent midline keel with lateral recession of the brows
        • from the frontal view these patients typically have the appearance of hypotelorism or decreased distance between the eyes
        • incidence of metopic synostosis in most cases of craniosynostosis is between 5-10%
        • deformity is usually obvious at birth, but the severity of the anomaly may vary
    • treatment involves releasing the suture and expanding and rounding out the upper face, forehead and skull

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