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Houston Cranio Facial

Coronal Craniosynostosis

The second most common form of craniosynostosis affects the coronal sutures. There are two coronal sutures, one on each side that run from ear to ear over the top of the skull at the anterior fontanelle (soft spot). If one suture is fused (unilateral coronal synostosis) it will cause flattening on the affected forehead with bulging of the opposite forehead. This is called plagiocephaly. The eye on the affected side will be pulled up. If both coronal sutures are fused (bilateral coronal synostosis) then the head shape is called brachycephaly with flatness of the forehead but a very tall head shape.

Surgery is necessary to correct coronal craniosynostosis. Some surgeons in the past have tried minimally invasive strip craniectomy (removal of the fused coronal suture bone) but with poor outcomes. The traditional method of frontal-orbital advancement with anterior cranial vault reconstruction and cranial bone grafting yields the best long term results. The goal is to over-correct the skull with expectation that the infant will grow into the new large forehead. Absorbable sutures, plates, and screws are used to secure the bone in place to create a new forehead shape and provide more skull space for continued brain growth. All the material used for the surgery will disappear with time as the body heals.