TRIANGULARIS SKULLS - ABOUT 87 CASES OF T RIGONOCEPHALY

The authors present 87 patients with trigonocephaly who were operated on. They take an interest in the consequence of the early synostosis o f the metopic suture. The metopic suture combine with the sagittal sut ural system, but his spot of manifestation is unambiguous. Its manage the dimension of the frontal bone which himself has repercussions on t he set of the orbits. Thereby the fronto-orbito-facial dysmorphy has t wo component parts. One direct with little frontal bone and a thick su tural spot which extend more or less to the bregma and a second indire ct with early deformation of the orbits and late deformation of the pa rietal bones. Three clinical patterns are described: micro-frontal sha pe, medio-frontal shape and orbito-frontal shape. In the pure shapes t here is no direct impact on the encephalon but the venous stasis is hi gh and probably liable for the encephalic damage when they exist. A si ngle surgical proceeding does not meet the many varieties of deformati ons. Resection of fused metopic suture from a bifrontal flap; confecti on of orbito-fronto-nasal band which is opened by greenstick fracture on the metopic site; transposition of an hemicoronal suture between th e two hemifrontal valves lateraly translated; foreward mobilisation an d interventing temporal flaps. To finish the modeling it is necessary to open the periosteum sheet in order to translate temporal muscles th en to overlay with interparietal pedicularly periosteum the anterior s tep. Metopic synostosis is ordinarily only an aesthetic deformity infr equently associated with intracranial pathology. The treatment must be required for pronounced deformities to prevent significant psychosoci al consequences.