The skull is a bony structure which forms the head of the human body. It supports the face structure and is the covering shell for the brain. The skull is made of two parts: The cranium and the mandible. These two parts of the skull are called the neurocranium and the viscerocranium, or facial bone which includes the mandible as the largest bone.
Abnormal skull shapes usually occur when the bones of the skull grow together. It is known as (suture fusion or synostosis) It can also happen when the bones of the skull are moved to a wrong place and are not fused (deformed). Most abnormal skull shapes come with birth.
Craniosynostosis (fusion of the skull bones):
The skull has five bones, with gaps between the bones, called sutures. These gaps allow the bones to move during the birth process. These sutures on the skull allow the brain and skull to grow as the baby grows. When one or more of these “sutures” grow together, the rest of the skull continues to grow in a different direction. This can result in the skull shape to be abnormal. This abnormal growth can be corrected surgically by a team of neurosurgeons and paediatric/craniofacial plastic surgeons.
These surgeries are mostly performed before one year of age; some are also performed at three to four months of age.
Below are a few common skull defects:
Plagiocephaly – It means a “crooked skull” or a deformed skull shape or synostosis of the uni-coronal suture (left or right).
Brachycephaly – Brachycephaly refers to a bicoronal synostosis (both coronal sutures are involved). This causes the forehead region to look extremely wide and high. The eyes of the person also appear wide apart.
Trigonocephaly – Trigonocephaly is a fusion of the metopic suture, which forms a triangular shaped forehead. The eyes may be close together and may look like a mild deformity of the forehead.
Multiple suture fusion – This happens when more than one suture is fused. The result of the head’s shape is dictated or formed based on the number and location of the suture. In cases of multiple suture fusion, a careful monitoring of intracranial pressures on the brain, and an earlier intervention of the brain is very important.