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Morphometric classification of cranial vault deformation in trigonocephaly: a preliminary study in 10 patients

Craniosynostosis including trigonocephaly is a skull deformity due to premature closure of calvarial sutures, as shown in Figure 1. In France, one birth on 2000 suffers from craniosynostosis (Renier et al. 2006). Foreign studies showed that the occurrence of craniosynostosis ranged between 1/1700 and 1/4000 births. Craniosynostosis can induce morphological and functional difficulties. First, esthetic problems concern dysmorphic skull or craniofacial area. Second, the growth conflict between skull and brain can create an intracranial hypertension leading to neuropsychological effects. Depending on the craniosynostosis type, mental and visual consequences may occur. The treatment often requires surgery to correct the deformity and prevent complications. Indications are depending upon the deformation level and functional risks, and the surgical technique has to be adapted to the craniosynostosis type and the child age. Among craniosynostosis classification, one can distinguished the trigonocephaly, which is due to a premature closure of the metopic suture (interfrontal suture) (Virchow 1851). A frequent complication is the pathological growth of cerebral frontal lobes when early surgery is avoided. Very few biomechanical or clinical studies involving classification concerned the trigonocephaly and the early diagnosis of the severity scale is missing. We hypothesised that a morphometric classification from computed tomography might be proposed to help into the objective quantification of trigonocephalic skull deformation (Renier et al. 2006).