Sagittal synostosis is the most common type of craniosynostosis. In this type, the anterior or posterior portion of the sagittal suture closes prematurely; the resulting compensatory growth causes frontal bossing. This causes your child’s skull to become long and narrow. This is sometimes called scaphocephaly.
Coronal synostosis is the second most common type of synostosis. In this type, one or both of the skull’s coronal sutures closes prematurely, resulting in head and facial asymmetry that gives an infant a wide skull with a forehead that is flat and tall. Your doctor or surgeon will call this shaped head brachycephaly. Surgery is required to open the fused sutures, reshape the head and allow for normal brain and skull growth.
Metopic synostosis is a premature closure of the metopic suture, resulting in a growth restriction of the frontal bones—which leads to a skull malformation known as trigonocephaly. This gives an infant a forehead that often looks pointed or triangular from above. Sometimes you may be able to feel a ridge in the middle of the forehead. Metopic synostosis also leads to facial abnormalities such as hypotelerism, resulting in a decrease in distance between the eyes. The goal of the surgery is to open the suture that is closed and to restore the natural shape of the forehead.
Lambdoid synostosis is one of the rarest forms of craniosynostosis. Unilateral lamdoid synostosis results in a flattening of the back of the head on the affected side, as well as compensatory growth of the mastoid process on the same side (ipsilateral mastoid bulge). This leads to a characteristic and unique “tilt” in the cranial base. This differentiates it from positional plagiocephaly, which is an abnormal flattening of the back of the head due to position of the child and not premature closure of suture. Positional plagiocephaly is treated primarily with repositioning of the child and surgery is only required if the lambdoid suture is closed or fused.
In some cases craniosynostosis is inherited and part of a genetic syndrome. Though these are extremely rare, an evaluation by a geneticist will help identify if your child has any of these syndromes.
Positional Plagiocephaly or positional head deformity, is when the back of the head is flattened with corresponding facial asymmetry secondary to prolonged positioning of a child on his/her back. Positional plagiocephaly is treated primarily with repositioning the child so that the non-flat side of the head is placed dependent against the mattress and encourage supervised “tummy time” on firm surfaces when the infant is awake. Rarely, and in severe cases, positional plagiocephaly may require treatment with helmet therapy.
Torticollis can also cause positional head deformity. Torticollis is when a child holds his/her neck towards one side. This tilted position can cause changes to the child’s face and head shape overtime. Physical therapy is often used to help correct abnormal neck position.