Comparison of computed tomographic imaging measurements with clinical findings in children with unilateral lambdoid synostosis.

BACKGROUND: In this study, the authors retrospectively reviewed 12 children with unilateral lambdoid synostosis to compare and contrast clinical findings and associated computed tomographic scan measurements for consistency.
METHODS: Multidisciplinary chart records were reviewed for descriptive findings of unilateral lambdoid synostosis. The preoperative computed tomographic scans underwent quantitative analysis of craniofacial morphology. The described clinical findings were compared with the associated computed tomographic measurements for consistency.
RESULTS: Clinical findings of unilateral lambdoid synostosis that were consistent with computed tomographic measurements included mastoid cant and bulge, and inferior ear position. Ipsilateral posterior ear position was clinically noted in half of the cases but was anterior in all cases on computed tomographic analysis. Trapezoid head shape was recorded in 11 of the 12 children but present in only eight computed tomographic scans. Median skull base deviation was 9 degrees for the posterior cranial fossa, 10 degrees for the middle cranial fossa, 6 degrees for mastoid cant, and 1 degree for facial twist. There was no correlation between degree of deformity and extent of suture fusion.
CONCLUSIONS: Mastoid bossing, skull base cant, and inferior ear deviation ipsilateral to the fused sutures were clinical findings that were consistent with computed tomographic measurements in these patients. Trapezoid head shape and posterior ear deviation were not. Radiographic suture fusion was observed in all cases; however, the extent of fusion did not correlate with the degree of deformity.