[Early radical operation of trigonocephaly in infancy--pathophysiological concepts and operative procedure of premature closure of the metopic suture].

The radical operative procedure for premature closure of metopic suture (trigonocephaly) was theoretically discussed on the basis of the pathophysiological concepts analyzed by the CT measurement. The authors experienced with 7 cases of trigonocephaly of infancy during the last 3 years. CT measurement for the analysis of development of the anterior cranial fossa/the orbital roof, was made on these cases setting up the standard of nasiopterional angle (N-P angle), nasio-clinoid angle (N-C angle), bi-pterional distance (B-P distance) and nasio-clinoid distance (N-C distance). Random sampling was done for the normal value or control from 30 normal childrens' CTs. The results revealed the fact that trigonocephaly in infancy has more markedly acute in N-P angle and short in B-P distance for more severely deformed trigonocephaly, but was within normal limit in N-C distance with normally shaped fronto-nasal angle. The theoretical operative goal for the early radical reconstructive procedure in trigonocephaly was felt that the lateral and superior orbital burrs should be advanced with the nasion as the key point until obtaining normal N-P angle and B-P distance. By performing the above procedure with tight fixation of 1 cm square bone fragment on each side, a satisfactory expansion of the anterior cranial fossa could be obtained as a result. The prematurely closed metopic suture should be stripped off down to the nasion to correct hypotelorism.(ABSTRACT TRUNCATED AT 250 WORDS)