Bicoronal
Bicoronal suture fusion results in a flat retruded forehead with increased height to the skull. This condition is also called brachycephaly due to the short anteroposterior diameter. As a result of this shortening there is a compensatory bulging of the transverse diameter or width of the skull. The brow is usually recessed and elevated with the deformity being symmetric. The incidence of bicoronal synostosis or brachycephaly is between 10-20% in most series of craniosynostosis.
This may occur as an isolated occurrence or part of a more complex syndrome with facial retrusion such as Apert’s or Crouzon’s. Surgical treatment consists of extended bicoronal craniectomies with reconstruction of the forehead. The supraorbital bar or brow is reshaped and advanced forward with the forehead. The reconstructed forehead and brow are secured to the nose and lateral orbits with resorbable suture and wires. If there is excessive height to the skull then total calvarial remodeling is also performed, decreasing the height of the skull.
