A 6x4x3 cm bone flap based on the right side, two thirds anterior and one third posterior to the coronal suture
with sagittal sinus exposure was used.
To resolve this problem, we use the frontal bone symmetrization method with craniotomy in the posterior aspect of the fused coronal suture
. The site of craniotomy in the affected side is determined by measuring the distance in the midline, lateral, and mid-way point in the unaffected side.
Brain three-dimensional tomography revealed synostosis in the coronal suture
The first two sides ran from the point Lambda to the point Bregma, and from the latter to that where the coronal suture
first touched the sphenoid bone (Pterion).
It is characterize by early union of the coronal suture
giving typical skull and facial deformity and sydactaly of hands and feet.3
The coronal suture
was studied in three parts on right and left side each; sagittal suture in four parts and lambdoid sutures in three parts each on right and left side.
long, extended onto face and terminating at level of antennal bases (Figs.
There were operative scars over Keen's point (2.5 cm superior and posterior to the top of the pinna) and over the left Kocher's point (2-3 cm from midline approximately in the mid pupillary line and 1 cm anterior to the coronal suture
) which was consistent with previous surgeries.
With the position of the bregma as the reference point, the coronal zero plane (AP0) passed through the coronal suture
. A1 and P1 were coronal planes 1 mm anterior and 1 mm posterior, respectively, to AP0.
Of the 16 patients included in the study, 14 presented with single-suture craniosynostosis: 6 involved metopic suture; 5, sagittal suture; and 3, coronal suture
.Nine cases were isolated fetal craniosynostosis, three were cases of Apert syndrome, and four also presented with associated CNS and non-CNS anomalies.
The most commonly encountered single suture synostoses are the sagittal suture (scaphocephaly) and the coronal suture
Encephaloceles are classified as occipital when found at or posterior to the lambdoid suture, parietal when found between the lambdoid and the coronal suture
and anterior when they occur anterior to the coronal suture