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Squamosal Suture Synostisis: An Unrecognized Phenomenon

Xiao Zhu, John H. Pang, Jonathan Y. Lee, Joseph E. Losee, Jesse A. Goldstein
University of Pittsburgh Medical Center
2017-02-14

Presenter: Xiao Zhu

Affidavit:
I certify that this abstract has not been previously published nor presented at a major meeting. The presenter has performed the majority of the work with respect to design, acquisition of data, analysis/interpretation, and drafting/revisions of the abstract.

Director Name: Vu T. Nguyen

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Introduction: The squamosal suture (SQS) is a poorly described site of synostosis. SQS fusion is reported to occur during the 4th decade; however, we incidentally noted its presence among our pediatric patients, and hypothesize that it may occur earlier or more frequently than previously believed.

Methods: A retrospective review of imaging performed on pediatric patients identified patients with SQS synostosis. This included a query of radiographic reports, and evaluation of CT 3D reconstruction images from our craniofacial clinic. Patient data and imaging were reviewed.

Results: 47 patients were identified with SQS synostosis. Age at diagnosis ranged from 17 days to 27 years. It was an isolated finding in 15 patients who were asymptomatic and required no surgical intervention. 32 patients had craniosynostosis of other sutures, most commonly sagittal, followed by coronal, lambdoid, and metopic synostosis. Nine had surgery to correct cranial deformities, and 27 had SQS synostosis diagnosed incidentally. Ten patients were syndromic, most frequent of which was Crouzon syndrome. Given that the majority were not found in isolation and the lack of cranial dysmorphology noted in those that were, no single calvarial deformity could be definitively described for SQS synostosis.

Conclusion: Our retrospective review identified 47 cases of SQS synostosis. Many were asymptomatic, were without significant cranial deformities, and were discovered incidentally; therefore, there may be many more cases of unidentified SQS synostosis. The significance of SQS synostosis is unclear, and warrants further investigation into its natural course and potential presence in the spectrum of normal development.

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