New classification system for sagittal cramosynostosis

Scaphocephaly is an important but incompletely defined entity resulting from premature fusion of the sagittal suture. Our goal was to utilize the clarity afforded by three-dimensional computed tomograms to discern what characteristics of this disease are most representative and singular. Furthermore, we sought to define a classification system wherein the dominant physical trait, as it results from varied sites of premature fusion, determines the type of scaphocephaly in a particular patient. All patients with CT diagnosed isolated single suture sagittal craniosynostosis seen by a single surgeon over a five year period are included (n=76). Patients were stratified into type A, B, C or D dependent on the presence of a single dominant characteristic as seen on CT scan. Type A features a transverse retrocoronal band; type B a heaped sagittal ridge; type C an especially prominent occiput; type D includes those patients in whom a single, dominant feature is not present. Heterogeneous points of initial fusion may be responsible for the differing representations. Clinical applications using this system are being developed.