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Clinical Significance of Clinocephaly in Late-Presentation Sagittal Craniosynostosis

Miles J. Pfaff, Regina Fenton, Madeleine K. Bruce, Jennifer Fantuzzo, Michael Bykowski, Joseph E. Losee, Jesse A. Goldstein
University of Pittsburgh Medical Center

Presenter: Miles Pfaff

Vu Nguyen

Director Name: Vu Nguyen

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

The diagnosis of late-presentation sagittal suture craniosynostosis (SCS) can be challenging, especially in the setting of subtle physical exam findings. The clinical significance of clinocephaly-a coronal concavity along the midvault-in this context remains unknown. The aim of this study is to evaluate the predictive value of clinocephaly in identifying late-presentation SCS.

A retrospective chart review of all patients >1 year of life presenting to the craniofacial clinic with a concern for SCS was performed. The presence or absence of SCS in the setting of clinocephaly was recorded following diagnostic imaging. Student's t test and Chi Square test were performed, p-value ≤ 0.05 was considered statistically significant.

81 patients met inclusion criteria. All patients presented with clinocephaly. Primary indication for imaging was an abnormal head shape. 31 of 81 (38.2%) patients were diagnosed with SCS. No difference in age between patients with and without SCS was detected (4.8 2.2 vs. 5.9 2 years, respectively; p=0.57); females were no more likely to present with SCS than males (p=0.3). Stratification of patients by age (1-2, 2-4, and >4 years) revealed no difference in the rates of SCS (p=0.36).

This study found that 38.2% of patients >1 year old who presented with clinocephaly had SCS. Clinocephaly is a unique physical exam finding that provides predictive value when evaluating patients presenting with late-presentation SCS. Future studies aimed at evaluating the sensitivity and specificity of this exam finding and identifying risk factors associated with late-presentation SCS are underway.

Author Contact Information:
Miles Pfaff
4401 Penn Avenue
Pittsburgh, Pennsylvania

412-692-5323 (cell)

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