Metopic Suture Synostosis: Open Vault Surgery: Key Points for the Neurosurgeon

Surgical treatment of premature closure of the metopic suture has been relatively rare because it is an unusual form of craniosynostosis, but surgery for this condition is becoming more common. Most cases of metopic synostosis occur as a single-suture pathology rather than in syndromic conditions. Clinical presentations and manifestations of metopic synostosis include trigonocephaly, hypotelorism, and temporal narrowing with abnormal shape of the supraorbital rim. Surgical treatment includes either endoscopic suture release or open vault surgery. Correction, when performed, must be tailored to the nature of the deformity. In this chapter, we discuss open vault surgery for metopic synostosis and highlight key points for the neurosurgeon.