PREOPERATIVE ANTHROPOMETRIC DYSMORPHOLOGY IN METOPIC SYNOSTOSIS

Anthropometric identification of dysmorphology in craniofacial anomali es, including the craniosynostoses, provides invaluable assistance in clinical diagnosis as well as offering a technique for interpreting po ssible deformities in skeletal remains, Premature closure of the metop ic suture is a rare form of craniosynostosis, representing about 4% of clinically diagnosed synostoses, Accompanying this closure are defect s of the head and face, particularly the upper face and orbits, To ide ntify quantitatively the craniofacial dysmorphology associated with me topic synostosis, 50 patients with a diagnosis of primary (nonsyndroma l) metopic synostosis were examined using a battery of 24 anthropometr ic measurements from which 11 proportion indices were calculated. The data were compared to sex- and age-matched normal standards and conver ted to standard (Z) scores before being analyzed using Student's t-tes t. The data indicate a complex pattern of dysmorphology arising from t he synostosis which affects the upper face and orbits as well as the c ranial vault. The entire fronto-orbito-zygomatic complex is narrowed, and vertex is reduced. There is compensatory sagittal and transverse g rowth of the posterior neurocranium and compensatory vertical and sagi ttal growth of the upper face. There are statistically significant dif ferences in the pattern of dysmorphology between patients presenting p rior to 6 months of age and those older but no significant differences between sexes. (C) 1997 Wiley-Liss, Inc.