Unilateral Coronal Synostosis (Clinical Presentation)

Figure kran_7a_n.jpg to kran_7d_n.jpg: Clinical presentation of a unilateral coronal synostosis on the right side in a 7-month-old girl, and corresponding CT findings and drawing. Figure kran_7a_n.jpg: In the view from the front there is a wide right lid fissure, a lateral and vertically dorsal displacement of the eye, and strabism. In addition, there is a right-left asymmetry of the face: The transverse axis of the lid edges, eyebrows, and mouth angles diverge in relation to the vertical axis of the face on the right side; therefore, the region of the right cheek is longer than the left, and there is a torticollis to the left. Figure kran_7b_n.jpg: In the view from the top the right frontal region is retracted; the roof of the right eye is insufficient, and there is a compensatory left-sided frontal protrusion; $$kran_1??nr=3££see alternate figure§§. Figure kran_7c_n.jpg: Both CT slices of another patient with a right coronal synostosis illustrate clearly that the anterior part of the basal and the facial skull is involved: The anterior part of the right skull base is steep and narrow in the anterior and lateral direction; therefore, the right minor sphenoidal wing and the smaller orbit becomes visible earlier in the slices from the top to the base than on the left side. In general, the basal and facial skull is involved in every type of craniosynostosis. Figure kran_7d_n.jpg: The reason of the involvement of the anterior basal skull is a premature closure of the basal sutures (arrows; Hoffman HJ, Mohr GJ. Neurosurg 45:376;1976).