The metopic suture runs down the midline of the forehead. Premature fusion of this suture results in a triangular shaped forehead called trigonocephaly. A bony ridge is usually palpable that extends from the bridge of the nose to the upper part of the forehead. This premature fusion produces a prominent midline keel with lateral recession of the brows. From the frontal view these patients typically have the appearance of hypotelorism or decreased distance between the eyes.
The incidence of metopic synostosis in most cases of craniosynostosis is between 5-10%. This deformity is usually obvious at birth, but the severity of the anomaly may vary. We prefer to correct these deformities between 9-12 months of age. Our current surgical treatment consists of frontal bone remodeling and supralateral orbital advancement.
The triangular or keelshaped forehead is removed and recontoured to the appropriate shape or bone may be taken from another area of the skull to replace this bone.
The entire bony supraorbital bar is removed and reshaped with supralateral orbital advancement to restore the normal brow contour.