The Natural History of Cranial Morphology in Sagittal Craniosynostosis.

BACKGROUND

Children with craniosynostosis have abnormal head shapes. Parents frequently ask whether the abnormal head shape will get worse with time. However, there is no information in the literature to indicate whether the deformity gets worse.

OBJECTIVE

To assess the progression of cranial morphology in children with unoperated craniosynostosis.

METHODS

A retrospective review of all children with unoperated sagittal craniosynostosis who were referred to the Craniofacial Clinic at the Hospital for Sick Children (SickKids) was conducted. Serial 3D photographs of patients with sagittal craniosynostosis who have not undergone surgical correction were included in the study. There were 14 cases included, with 9 males and 5 females. Ages at time of scans ranged from 3 months to 5 years of age (mean = 28.3 months, SD = 28.2 months). Nine patients had the first scan at age of <12 months. Multiple scans for each patient were sized for volume over time and compared with a normative skull database.

RESULTS

The results of measuring skull volume changes over time revealed no significant difference from infants without craniosynostosis. Furthermore, there cranial index was stable over time in patients with craniosynostosis.

CONCLUSION

The severity of craniosynostosis does not worsen or improve with time. Parents having difficulty in deciding to proceed with surgical correction of craniosynostosis can be reassured that the skull deformity will remain stable with the growth of their child if they decide not to proceed with surgical correction.