Cranial base changes following surgical treatment of craniosynostosis.

Three-dimensional osseous surface images from CT scans have been used to study the endo- and exocranial bases of 87 patients with a variety of craniosynostoses. Patients were studied prior to cranial surgery in infancy, perioperatively, and 1 year postoperatively. The dysmorphology of the endocranial base is diagnostically specific for synostosis of the metopic, sagittal, unicoronal, and bicoronal sutures. Cranio-orbital surgery in infancy for nonsyndromal solitary and bicoronal synostosis seems to induce normalization of endocranial symmetry in the first postoperative year. This normalization occurs to a lesser degree in patients with multiple synostoses. These findings suggest that the cranial base dysmorphology of craniosynostosis is a secondary manifestation of an undefined primary disorder. Furthermore, persistent postoperative dysmorphology may reflect abnormal neural rather than osseous growth.