title: Does patient ethnicity affect site of craniosynostosis?
abstract: OBJECTIVE
  There are no published papers examining the role of ethnicity on suture involvement in nonsyndromic craniosynostosis. The authors sought to examine whether there is a significant difference in the epidemiological pattern of suture(s) affected between different ethnic groups attending a regional craniofacial clinic with a diagnosis of nonsyndromic craniosynostosis.
  
  
  METHODS
  A 5-year retrospective case-notes analysis of all cases involving patients attending a regional craniofacial clinic was undertaken. Cases were coded for the patients' declared ethnicity, suture(s) affected by synostosis, and the decision whether to have surgical correction of synostosis. The chi-square test was used to determine whether there were any differences in site of suture affected between ethnic groups.
  
  
  RESULTS
  A total of 312 cases were identified. Of these 312 cases, ethnicity data were available for 296 cases (95%). The patient population was dominated by 2 ethnic groups: white patients (222 cases) and Asian patients (56 cases). There were both more cases of complex synostosis and fewer cases of sagittal synostosis than expected in the Asian patient cohort (χ(2) = 9.217, p = 0.027).
  
  
  CONCLUSIONS
  There is a statistically significant difference in the prevalence of the various sutures affected within the nonsyndromic craniosynostosis patient cohort when Asian patients are compared with white patients. The data from this study also suggest that nonsyndromic craniosynostosis is more prevalent in the Asian community than in the white community, although there may be inaccuracies in the estimates of the background population data. A larger-scale, multinational analysis is needed to further evaluate the relationship between ethnicity and nonsyndromic craniosynostosis.
authors.affiliation: Department of Neurosurgery, Leeds General Infirmary;
authors.forename: Ian A
authors.initials: IA
authors.lastname: Anderson
authors.forename: Anand
authors.initials: A
authors.lastname: Goomany
authors.forename: David T
authors.initials: DT
authors.lastname: Bonthron
authors.forename: Maggie
authors.initials: M
authors.lastname: Bellew
authors.forename: Mark I
authors.initials: MI
authors.lastname: Liddington
authors.forename: Ian M
authors.initials: IM
authors.lastname: Smith
authors.forename: John L
authors.initials: JL
authors.lastname: Russell
authors.forename: Lachlan M
authors.initials: LM
authors.lastname: Carter
authors.forename: Velupandian
authors.initials: V
authors.lastname: Guruswamy
authors.forename: John R
authors.initials: JR
authors.lastname: Goodden
authors.forename: Paul D
authors.initials: PD
authors.lastname: Chumas
mesh_terms: D000293:Adolescent; D044466:Asian People / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000208:ethnology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan / Q000208:ethnology; D012189:Retrospective Studies; D012886:Skull / Q000002:abnormalities*; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: NHS = UK National Health Service; craniofacial surgery; craniosynostosis; epidemiology; ethnicity; genetic; nonsyndromic; pediatric