PubMed · 5244908
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P Herren. 1967. Introduction to the programme.. https://pubmed.ncbi.nlm.nih.gov/5244908/
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BACKGROUND: Premature closure of the metopic suture leads to inhibited growth of the frontal bones, producing a keel-shaped forehead (trigonocephaly). Simple metopic synostosis is usually sporadic. Trigonocephalic patients account for 8-16% of the referrals to craniofacial centers, with a marked male predominance. Intracranial pressure (ICP) may be increased, whereas shunt-dependent hydrocephalus is infrequent. Infrequently, patients have intra- or extracerebral anomalies; one third have varying degrees of neuropsychological problems. The treatment is primarily surgical. MATERIAL AND METHODS: We present two patients who during infancy developed increasingly keel-shaped foreheads, retruded orbital rims, increased biparietal diameter and close-set eyes (hypothelorism). Both had raised ICP, but normal psychomotoric development. They were operated using radical fronto-orbital surgical remodelling. RESULTS: Recovery was uneventful. Three months post-operatively, they had pleasing cosmetic results with no symptoms of increased ICP. INTERPRETATION: Where metopic craniosynostosis is suspected, the infant should be examined clinically with palpation of fontanelles and sutures, evaluated with respect to the shape and development of the facial skeleton, as well as by X-ray of the skull sutures. Radical fronto-orbital surgical remodelling gives a stable correction of the craniofacial deformity and generally a satisfactory cosmetic result.
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Facial reconstruction using 3-D computer graphics is being used in our institute as a routine procedure in forensic cases as well as for skulls of historical and archaeological interest. Skull and facial data from living subjects is acquired using an optical laser scanning system. For the production of the reconstructed image, we employ facial reconstruction software which is constructed using the TCL/Tk scripting language, the latter making use of the C3D system. The computer image may then be exported to enable the production of a solid model, employing, for example, stereolithography. The image can also be modified within an identikit system which allows the addition of facial features as appropriate.