Comparative 3-Dimensional Analysis of Isolated Unilateral Squamosal Craniosynostosis.

Abstract

Purpose: Squamosal craniosynostosis (SQS) is a rare form of craniosynostosis involving the minor squamosal suture that runs laterally joining the temporal and parietal bones. Due to the limited reported incidence of the disease, the pathologic effects have not been thoroughly studied, and no standardized treatment plan has been established. This study strives to understand the effects squamosal craniosynostosis has on intracranial volume to determine a basis for targeted surgical intervention.

Methods: A 3-dimensional analysis was performed on head computed tomography (CT) scans of 4 patients diagnosed with SQS at a single institution between 2018 and 2024. The CT scans were compared with age-sex-matched controls. Cranial indices (CI) and intracranial compartment volumes were analyzed with SyngoVia. Paired t tests examined differences between the patients and their control subjects.

Results: While this study's data showed an overall trend of lower cranial indices and intracranial volumes in patients with squamosal craniosynostosis compared with their age-sex-matched control counterparts, only specific volumetric measurements demonstrated a clinically significant difference. The intracranial volumes of the middle and posterior compartments, and the total intracranial volume were significantly lower in patients with squamosal craniosynostosis (P=0.03, 0.006, 0.03, respectively).

Conclusion: This study demonstrates a significant difference in intracranial volume distribution in patients with SQS compared with age-sex-matched controls. This decrease in intracranial volume is primarily observed in the middle and posterior compartments, suggesting potential anatomic regions to address with surgical intervention.