title: The Severity of Deformity in Metopic Craniosynostosis Is Correlated with the Degree of Neurologic Dysfunction.
abstract: BACKGROUND
  In recent years, metopic synostosis has represented up to 25 percent of all nonsyndromic craniosynostosis cases, manifesting with varying degrees of trigonocephaly. It is unknown whether the degree of severity of anterior dysmorphology is proportionate to neurologic dysfunction. This knowledge is essential to guide future surgical treatment recommendations. Given the reported correlation of abnormal auditory processing with future language dysfunction and poorer academic performance in craniosynostosis patients, the present study aims to evaluate auditory processing in preoperative patients with moderate and severe metopic synostosis, and in control infants, to discern the neurologic risk carried by different severities of trigonocephaly.
  
  
  METHODS
  Thirty-eight infants underwent evaluation of auditory processing: nine patients with severe metopic synostosis, seven with moderate metopic synostosis, and 22 controls. Brain activity was recorded by electroencephalography while the participants listened to language-based stimuli. Electroencephalographic data were analyzed to extract event-related potentials evoked by the speech sounds.
  
  
  RESULTS
  Severe metopic synostosis patients demonstrated significantly attenuated event-related potential responses in the left frontal scalp region overlying the left frontal lobe compared with controls (p < 0.05). The moderate metopic synostosis patients did not show significantly different language processing compared to the control infants or the severe metopic synostosis patients in the frontal scalp region.
  
  
  CONCLUSIONS
  The results of this study suggest that untreated severe metopic synostosis is associated with reduced language response in the frontal cortex. Less severe (moderate) forms are indeterminate, and mild forms do not show calculable irregularity by the event-related potential method of analysis.
  
  
  METHODS
  Risk, II.
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Jenny F
authors.initials: JF
authors.lastname: Yang
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Brooks
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Hashim
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Hannah S
authors.initials: HS
authors.lastname: Reuman
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Roberto
authors.initials: R
authors.lastname: Travieso
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Jordan
authors.initials: J
authors.lastname: Terner
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Mayes
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: Derek M
authors.initials: DM
authors.lastname: Steinbacher
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: John A
authors.initials: JA
authors.lastname: Persing
authors.affiliation: New Haven, Conn.|From the Section of Plastic and Reconstructive Surgery and the Child Study Center, Yale University School of Medicine.
authors.forename: James C
authors.initials: JC
authors.lastname: McPartland
mesh_terms: D001921:Brain / Q000503:physiopathology*; D003398:Craniosynostoses / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index