Single Suture Craniosynostosis at North Austin Campus

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Infants with craniosynostosis can have early closure of one or more growth sutures of their skull. It is most common to have only one suture close early, known as “single suture craniosynostosis”. There are ‘major’ and ‘minor’ growth sutures of the skull. Early closure of a minor cranial suture is rarer and usually does not need surgery. Early closure of a major cranial suture usually does need surgery to allow the brain to grow normally. Early major suture fusion causes a specific head shape to form as the closed (“fused”) suture restricts growth in one direction and the open sutures allow growth in other directions. The major cranial suture fusions in order of frequency are:

Sagittal suture synostosis

Early closure of the sagittal suture is the most common type of single suture craniosynostosis
The sagittal suture runs from a baby’s soft spot along the middle of the top of the head
Early closure causes a head shape called “scaphocephaly” or “boat-shaped”
We offer a number of treatments based on your child’s age and your family’s preference. These include open cranial vault remodeling, endoscopic strip craniectomy with a molding helmet, and spring-assisted cranioplasty.

Coronal suture synostosis

Early closure of the coronal suture is the second most common type of single suture craniosynostosis
The coronal suture runs from a baby’s soft spot along the side of their head
Early closure causes a head shape called “anterior plagiocephaly” or “flat forehead”
We offer a number of treatments for unilateral coronal synostosis based on your child’s age and your family’s preference. These include open cranial vault remodeling, endoscopic strip craniectomy with a molding helmet, and spring-assisted cranioplasty.
In some cases both coronal sutures can close which is called bilateral coronal synostosis. This causes flatness of both sides of the forehead, resulting in a short but wide head known as “brachycephaly”. This suture fusion pattern can occur in certain syndromes like Apert syndrome, Crouzon syndrome, Muenke syndrome and Saethre Chotzen syndrome.

Metopic suture synostosis

Early closure of the metopic suture is the third most common type of single suture craniosynostosis and has become more common over the past decade. No one knows why but research is ongoing.
The metopic suture runs from a baby’s soft spot down the middle of their forehead
The metopic suture usually closes normally at 2 to 8 months of age, so if a metopic suture is closed on a CT scan after 8 months of age it may be perfectly normal.
Metopic synostosis causes a triangular head shape or “trigonocephaly”. It also results in some difference in the eye sockets, which are usually closer together (“hypotelorism”).
Metopic synostosis can be confused with a normal head variation called “Metopic Ridge”. An experienced team like in North Austin can tell the difference with a careful physical examination in clinic. Metopic Ridge does not need any surgery and usually goes away with time.
We offer a number of treatments for metopic synostosis based on your child’s age and your family’s preference. These include open cranial vault remodeling, endoscopic strip craniectomy with a molding helmet, and spring-assisted cranioplasty.

Lambdoid suture synostosis

Lambdoid synostosis is a rare form of craniosynostosis where one or both of the growth sutures at the back of the head close early.
Lambdoid synostosis causes flatness at the back of the head and can be confused with another condition that can cause flatness called deformational plagiocephaly.
Unlike deformational plagiocephaly, lambdoid synostosis can affect the growth of an infant’s brain and cause pressure and therefore it is important not to miss the diagnosis.
The craniofacial team in North Austin have experience in knowing the difference between lambdoid synostosis and deformational plagiocephaly based on a physical examination.

If your Texas Children's surgeon suspects lambdoid synostosis they will order a CT scan to confirm that the lambdoid suture is actually closed and if surgery is needed.
We offer several surgical options for the treatment of single suture lambdoid synostosis in North Austin including endoscopic strip craniectomy, spring cranioplasty, and open cranial vault remodeling.
In very rare cases, both of the lambdoid sutures close early as well as the sagittal suture. Because this results in a three-prong fusion pattern that looks like the car symbol, it has been called “Mercedes Synostosis”. A more accurate name is bilateral lambdoid and sagittal synostosis (BLSS). This is a more severe form of craniosynostosis and can include heart conditions as well as a specific brain condition known as Chiari 1 malformation. Our team usually recommends open cranial vault remodeling for BLSS for safety reasons.