41. Craniosynostosis What is metopic synostosis? The metopic suture begins at the nose and continuessuperiorly to meet the sagittal suture. What is sagittal synostosis? http://www.pedisurg.com/PtEduc/Craniosynostosis.htm

CRANIOSYNOSTOSIS What is craniofacial surgery? Craniofacial surgery is a surgical subspecialty developed by Paul Tessier thirty years ago in France. It involves surgery of the skull and face for tumors, trauma, and congenital deformities. For many years, the severity of these conditions was thought too risky for surgical intervention. Tessier, a surgeon himself, challenged this belief and began building the foundation of craniofacial surgery. In doing so, he recognized that this complex form of surgery could only be performed by a specially trained surgeon who was supported by a highly skilled team. The surgical team at Hermann Children's Hospital includes a pediatric neurosurgeon and craniofacial surgeon as well as a specialized anesthesiologist. The neurosurgeon works on the skull and the craniofacial surgeon on the face. With both areas being closely related the combined approach offers the best possible results with the highest level of safety. What is craniosynostosis? Diagram of skull, showing location of fontanelles and sutures The skull of an infant is made up of free-floating bones separated by fibers called sutures. This arrangement allows the infant's head to pass through the birth canal and also enables the skull to grow with the brain in early infancy.

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43. Subject Index, Right Reduction of transfusion rates in the surgical correction of sagittal synostosisJ Neurosurg Abstract Full Text PDF (64K), sagittal synostosis, http://www.thejns-net.org/si/si_S.html

In this index in alphabetical order are listed keywords of all articles and letters. Names which begin with a prefix are entered under the prefix. S S phase Detection of proliferating S-phase brain tumor cells by in situ DNA replication [ J Neurosurg Abstract Full Text PDF (469K) S-1 lamina Management of low lumbar fractures by dorsal decompression, fusion, and lumbosacral laminar distraction fixation [ J Neurosurg Spine Abstract Full Text PDF (99K) S-100 protein family Expression of members of the calcium-binding S-100 protein family in a rat model of cerebral basilar artery vasospasm [ J Neurosurg Abstract Full Text PDF (1415K) S-100 protein Differences in critical cerebral blood flow with age in swine [ J Neurosurg Abstract PDF (388K) Spinal malignant nerve-sheath tumor or cellular schwannoma? A striking difference in prognosis [ J Neurosurg Abstract PDF (543K) Serial S-100 protein serum measurements related to early magnetic resonance imaging after minor head injury [ J Neurosurg Abstract PDF (172K) Fatal secondary increase in serum S-100B protein after severe head injury [ J Neurosurg Abstract Full Text PDF (58K) Does administration of recombinant human erythropoietin attenuate the increase of S-100 protein observed in cerebrospinal fluid after experimental subarachnoid hemorrhage? [

44. Plagiocephaly - Research, Clinical Studies, News, Parent's Discussion Board For Preliminary Results and New Treatment Protocol for Cranial Banding Following EndoscopicAssistedCraniectomy for sagittal synostosis This study describes how http://www.cranialtech.com/ParentsArea/researchArticles.html

Discussion Board Photo Album DOC Band Calendar ... Parents' Pages Library News Articles Links Is One Twin at Greater Risk? This study confirmed that the infant carried lower in the uterus was at greater risk for both plagiocephaly and torticollis. Littlefield TR, Kelly KM,Pomatto JK, Beals SP; Pediatrics (pdf file) News Release from AAP (online link) Diagnosis and Management of Positional Plagiocephaly A great A-Z summary of plagiocephaly, what causes it and treatment options. Written in lay terms with some wonderful handouts for repositioning and neck stretching exercises. Littlefield TR, Reiff JL, Rekate, HL. BNI (online link) Preliminary Results and New Treatment Protocol for Cranial Banding Following Endoscopic-Assisted Craniectomy for Sagittal Synostosis This study describes how the DOC Band is used after endoscopic surgery for sagittal synostosis. Pomatto JK, Beals SP, Joganic EF, Moss SD, Kelly KM, Littlefield TR (2001). Proceedings of the 9th International Congress of the International Society of Craniofacial Surgery; pp:47-49 (pdf file) Food and Drug Administration Regulation of Orthotic Cranioplasty.

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46. Directory :: Look.com sagittal synostosis (3) sagittal synostosis Homepage Information (including detailsof genetic research) and support for people affected by this condition. http://www.look.com/searchroute/directorysearch.asp?p=58496

47. Cure For Sagittal Synostosis - Sagittal Synostosis Treatment - Sagittal Synostos We offer solution for sagittal synostosis, sagittal synostosis treatment services,medical information about sagittal synostosis, sagittal synostosis advice http://www.procab.ch/dir/sagittal_synostosis/

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48. The Contact A Family Directory - CRANIOFACIAL CONDITIONS Most common (45%) is sagittal synostosis, which gives a long, narrow head; next mostfrequent is coronal synostosis (20%), which may affect one side (unilateral http://www.cafamily.org.uk/Direct/c78.html

printer friendly CRANIOFACIAL CONDITIONS home more about us in your area conditions information ... how you can help search this site Abnormalities of skull shape can arise either from external pressure exerted on the head in early life, or from intrinsic abnormalities of growth. The most common intrinsic abnormality of skull growth is called craniosynostosis, which affects about 1 in 2,500 children. Craniosynostosis is the medical term for the premature closure of one or more of the seams between the skull bones. As the brain grows during fetal life and childhood, the overlying skull also enlarges by adding new bone at these seams, which are termed sutures. The major sutures are the midline metopic (at the front) and sagittal (at the top) sutures, and the paired coronal and lambdoid sutures. The coronal sutures run across the skull in front of the ears, crossing the junction of the metopic and sagittal sutures; the lambdoid sutures divide from the back end of the sagittal suture and run obliquely forwards to end up behind the each ear. The remaining 20% of craniosynostosis is more complex and either involves the fusion of multiple sutures (5%), and/or is combined with additional changes in the face, limbs or other parts of the body, indicating a "syndrome" (15%). Over 100 craniosynostosis syndromes have been described, most of which are extremely rare; the most common syndromes are Crouzon, Pfeiffer, Apert, Muenke, Saethre-Chotzen and craniofrontonasal syndromes. In these complex cases, there may be additional problems with the vision, breathing, hearing, teeth, learning development, facial appearance and malformation of the limbs and other organs.

49. Periop Data Set Transformed Into Postop Data Set And Vice Versa We wanted to transform a 3D CT data set of a 5 month old infant head after the surgeryto correct the sagittal synostosis (periop) into a 3D CT data set of a http://css.engineering.uiowa.edu/~gec/fcmckee/Infant_B/infant_b/perib2postb.html

Periop Data Set transformed into Postop Data Set and vice versa Rigid Image Registration Consistent Linear-Elastic Image Registration Validation Visual Inspection ... Visualization Rigid Image Registration We wanted to transform a 3D CT data set of a 5 month old infant head after the surgery to correct the sagittal synostosis (periop) into a 3D CT data set of a 16 month old infant head (postop). Before we could do this, we had to rigidly register the data sets through rotation and translation. The periop and postop data sets were rigidly registered along the Frankfort Horizontal and Midsagittal planes with the sella turcica being the origin of the coordinate system. Click on image for animated gif image. Consistent Image Registration The results below show the transformation of a 5 to 16 month old infant head with sagittal synostosis with respect to the sella turcica (origin). The 3D CT data set taken after surgery at 5 months of age (periop) was transformed into the shape of the 3D CT data set taken after surgery at 16 months of age (postop). These results were generated using a consistent linear-elastic transformation. The Periop image was used as the template and the Postop image was used as the target . The images below show the skin and skull surface renderings of the template, target, deformed template, and deformed target.

50. Welcome To The CAPPS Board sagittal synostosis symptoms as adult? Diagnosed w/sagittal synostosis@ age 3, 2, 10/13/02 74949 pm by merrellacey, Ejrquinn. http://pub32.ezboard.com/fcappsmessageboardfrm1?page=2

51. Johns Hopkins Epidemiology Of Cranio About 810% of coronal synostosis patients have a positive family history of thedisorder, but only about 2% of sagittal synostosis present as familial forms http://www.cappskids.org/EpidemiologyOfCranio.htm

CAPPS THE ORGANIZATION SUPPORT CAPPS GUARDIAN ANGELS PAGE CAPPS FAMILY FUNDRAISING PAGE ... HELPFUL LINKS CRANIO PLAGIO CLICK LOGO TO ENTER CAPPS ONLINE STORE CLICK LOGO TO ENTER THE CRANIOKID STORE CLICK LOGO TO ENTER THE PLAGIOKID STORE CLICK LOGO FOR DOLLS BY SHELBY CLICK LOGO FOR ITEMS OF INTEREST AT AMAZON.COM 6905 Xandu Court Fredericksburg, VA 22407 Cranio: 540-786-9563 Plagio: 845-454-5902 EPIDEMIOLOGY AND GENETICS OF CRANIOSYNOSTOSIS Few epidemiologic studies of craniosynostosis have been performed. Reported incidence varies from 3-5 per 10,000 (Cohen, 1986) to as high as 10 per 10,000 (French et al., 1990). These discrepancies may be due to different methods of ascertainment, i.e., surgical (Lammer et al., 1997) vs. medical cases, or may result from different diagnostic criteria used to differentiate between isolated and syndromic cases. Prospective analysis of 29,235 births in a single hospital identified 18 cases over an 8 year period, yielding a birth prevalence of 6 per 10,000 for isolated non-syndromic cases (Shuper et al., 1985). Epidemiologic study conducted in Western Australia between 1980-1994 documented prevalence of 5.02 per 10,000 births (Singer et al., 1999). Most commonly non-syndromic craniosynostosis occur sporadically. About 8-10% of coronal synostosis patients have a positive family history of the disorder, but only about 2% of sagittal synostosis present as familial forms (Hunter and Rudd, 1976; 1977; Shuper et al., 1985). However, some of the patients with coronal synostosis may have been misdiagnosed as non-syndromic, due to the extreme variability of some Mendelian syndromes.

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53. Faculty Panchal J, Pilgram T, Marsh J L. Photographic assessment of head shapefollowing sagittal synostosis surgery. Plastic and Reconstructive http://w3.uokhsc.edu/surgery/CV_panchal.asp

CURRICULUM VITAE JAYESH PANCHAL ACADEMIC QUALIFICATIONS M.B.B.S (Bachelor Medicine Bachelor Surgery) October 1982 Grant Medical College University of Bombay MS (Gen. Surg) (Master of Surgery) July 1987 Grant Medical College University of Bombay Fellow Royal College Surgeons May 1990 Royal College Of Surgeons and Physicians Of Glasgow Fellow Royal College Surgeons June 1990 Royal College Of Surgeons Of Edinburgh Fellow Royal College Surgeons September 95 Intercollegiate Board Exam in Plastic Surgery Royal College of Surgeons of Edinburgh PROFESSIONAL EXPERIENCE: Academic Appointment: 8/21/97 to present: Assistant Professor, (tenure track)Section of Plastic Surgery, University of Oklahoma Health Sciences Center, University of Oklahoma Director 8/21/97 to present Director, Craniofacial Team, Cleft and Craniofacial Team @ Children's Hospital of Oklahoma POSTGRADUATE TRAINING AND RESIDENCY: 8/1/90 to 5/31/91 Junior Resident, Plastic Surgery; Leicester Royal Infirmary, Leicester, England.

54. JAYESH PANCHAL, M.D. - Resumé 4. Photographic assessment of head shape following sagittal synostosis surgery JayeshPanchal, Thomas Pilgram , Jeffrey Marsh , St Louis Children’s Hospital http://moon.ouhsc.edu/jpanchal/resume.html

ACADEMIC QUALIFICATIONS M.B.B.S October 1982 Grant Medical College University of Bombay MS July 1987 (General Surgery) Grant Medical college University of Bombay FRCS May 1990 (General Surgery) Royal College Of Surgeons and PhysiciansOf Glasgow FRCSEd. June 1990 (General Surgery) Royal College Of Surgeons Of Edinburgh FRCS (Plastic Surg) September 95 Intercollegiate Board Exam in Plastic Surgery Royal College of Surgeons of Edinburgh SUMMARY OF TRAINING IN PLASTIC SURGERY POST HOSPITAL DURATION Junior Resident Plastic Surgery Leicester Royal Infirmary, Leicester England 8.1.90 to 5.31.91 (10 months) Junior Resident Plastic Surgery Kingston General Hospital Hull Royal Infirmary, Hull England 6.1.91 to 5.31.92 (12 months) Senior Resident Plastic Surgery 6.1.92 to 2.18.94 (20 months) Chief Resident Plastic Surgery Cork University Hospital, Cork Ireland 3.22.94 to 7.09.95 (15 months) Locum Attending Plastic Surgery Cork University Hospital, Cork Ireland 7.10.95 to 9.03.95 (2 months) Chief Resident Plastic Surgery Cork University Hospital, Cork Ireland

55. Jayesh Panchal, M.D. - Publications 8. Photographic assessment of head shape following sagittal synostosis surgery InPress Plastic and Reconstructive Surgery Journal Jayesh Panchal, Thomas http://moon.ouhsc.edu/jpanchal/pub.html

PUBLICATIONS IN INTERNATIONAL JOURNALS 1. "Early Postoperative Brachytherapy and Free Flap Reconstruction" in British Journal of Plastic Surgery 1993;46:511-15 Mr. J. Panchal, Mr. R. Agrawal, Mr. N. R. McLean, Department of Plastic Surgery, Newcastle upon Tyne 2. "Management of sarcomas with early post-operative brachytherapy" European Journal of Oncology. 1996;22:144-46 Mr. J. Panchal, Mr. R. Agrawal, Mr. N. R. McLean, Department of Plastic Surgery, Newcastle upon Tyne 3. "Objective Assessment of speech and swallowing in patients with free flap reconstruction oral cavity cancer". British Journal of Plastic Surgery. 1996;49:363-69. Mr. J. Panchal, Dr. J. Potterton, Mrs. E. Scanlon, Mr. N. R. McLean, Department of Plastic Surgery, Newcastle upon Tyne. st Place Winner : Clinical research Category Junior Division Plastic Surgery Educational Foundation Scholarship Essay Competition 1998

56. Hospital Links sagittal synostosis = fusion of the midline sagittal suture, growth fails to occuracross the head and excessive growth occurs from front to back leading to http://headlines.org.uk/SingleSuture.htm

Single Suture Craniosynostosis Back One of the UK Supra Regional Hospitals can give you more advice SINGLE SUTURE CRANIOSYNOSTOSIS : in the vast majority of cases the compensatory growth of the normal sutures is generally sufficient to allow the developing brain to grow without causing raised pressure. However, in a certain percentage of cases the restriction is such that the pressure within the skull rises (raised intracranial pressure). There are a number of reasons why surgery may be indicated for the treatment of an established disfigurement to attempt to prevent the progression of a developing disfigurement to relieve raised intracranial pressure to decrease the risk of developing raised intracranial pressure or other functional pressure-related affects. Types of single suture craniosynostosis: Sagittal synostosis = fusion of the midline sagittal suture, growth fails to occur across the head and excessive growth occurs from front to back leading to Scaphocephaly = boat shaped head Metopic synostosis = fusion of the anterior midline suture with failure of adequate transverse growth in the forehead, and compensatory growth posteriorly and laterally leading to

57. Craniofacial Surgery...David Herz, M.D. This is sagittal synostosis, where the suture along the top of the head closesprematurely. It produces an abnormally shaped head termed scaphocephaly. http://www.drherz.com/C_OurPractice/C33_Craniofacial.html

What is craniofacial surgery? Craniofacial surgery consists of operations on the soft tissues and bones in the head and face. These operations are done primarily on children born with abnormal shapes of the head and face. Sometimes such surgery is done in patients suffering with tumors, injuries or other disorders. Why is it done? The most common reason for doing craniofacial surgery is to correct abnormal head and face shapes, which certain children are born with or develop after birth. This is due to craniosynostosis. What is Craniosynostosis? In this disorder, a child presents with a characteristic deformity of the head, or head and face. It is typically an intrauterine (inside the womb) event. This is probably due to a misdirected message from a gene. It is not due to a defect in parents. Sometimes, postnatal (after birth) synostosis can occur as well. There are rare cases where this is due to inborn errors of metabolism where the body chemicals affect bone growth abnormally. Figure 1 In babies, the skull bone is not one large vault as we see in adults. Rather, there are numerous bones (

58. Appearance Term Cause Oval In Transverse Plane Normal Length turricephaly (oxycephaly acrocephaly). coronal and sagittal synostosis forcing theskull to grow vertically. References Hall JG FrosterIskenius UG Allanson JE. http://www.medal.org/docs_ch2/doc_ch2.13.html

Measurement of the Craniofacial Dimensions Table of Contents, Chap. 2 Suture Fusion and Skull Shape Overview: Synostosis is the fusion of bones during development and occurs along the suture lines of the skull. If the synostosis occurs prematurely the normal expansion of the cranial vault may be prevented resulting in abnormal shape or asymmetry. The growth inhibition occurs at right angles to the closed suture. and is affected by the order and timing of closure relative to the closure of the other sutures. Sutures in the skull (1) metopic (single midline) (2) coronal (paired) (3) sagittal (single midline) (4) lambdoidal (paired) (5) squamosal (paired) Appearance Term Cause oval in transverse plane normal length symmetrical normocephaly normal closure of the sutures anterior half of skull triagonal in transverse plane often with ocular hypotelorism trigonocephaly premature closure of the metopic suture round in transverse plane with flattend occiput brachycephaly premature closure of both coronal sutures oval in transverse plane but increased length symmetrical dolichocephaly premature closure of the sagittal suture ovoid in transverse plane but asymmetrical plagiocephaly premature closure of one coronal (anterior asymmetry) or one lambdoidal (posterior asymmetry) outline of skull small in the transerse plane; cranial vault higher but narrower than normal

59. Listings Of The World Health Support Groups Conditions And Listings World Health Support Groups Conditions and Diseases FacialDifferences sagittal synostosis. Listings World, http://listingsworld.com/Health/Support_Groups/Conditions_and_Diseases/Facial_Di

60. CRANIOSYNOSTOSIS 4) The periosteum overlying the suture may be involved. ASSOCIATED DISORDERSThe sagittal synostosis is rarely associated with other abnormalities. http://www.thamburaj.com/craniosynostosis.htm

Craniosynostosis: Dr. A. Vincent Thamburaj. N eurosurgeon, Apollo Hospitals, Chennai , India. You may try the links, recommended below, for more. Craniosynostosis is the premature partial or complete ossification of one or more of the sutures separating the membranous bones of the skull. Primary craniosynostosis is almost always present prenatally except in some with cranio facial syndromes of Crouzan's, Apert's and Carpenter's type in whom progressive postnatal closure may occur. It is called 'simple' when one suture is involved,’ compound' when more than one is involved. Secondary stenosis occurs in children with microcephaly and in some who have had shunts in place for hydrocephalus. In some Rickets, Hyperthyroidism, Thalassaemia, or Mucopolysaccharidosis may be associated. PATHOGENESIS: The cranial vault develops intramembranous bone formation between the periosteum and the dura. This process begins during the 6th week of embryonic development. The posterior fontanel closes at 3 mths of age and the anterior one, at 8mths of age. The bones ossify by the end of first year. The skull growth ceases by 10-12 yrs of age. The ossification of the cranial sutures occurs by the 4th-5th decade. The base develops from a series of primordial cartilages that undergo ossification. The growth of the base proceeds at a slower rate. The skull contains two types of sutures- syndesmoses and synchondroses.

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