Also Known As Trigonocephaly The metopic suture is located at
the front of the head and separates the frontal bones. It allows
for transverse growth of the frontal bones and a widening of the
anterior cranial fossa as the brain grows. This suture is the
only one that naturally closes in childhood, between the ages of
0-2 years old. “Normal “closure of this suture typically results
in the formation of a prominent midline ridge which is often
felt along the middle of the forehead. “Premature” closure,
however, causes more than a ridge. There is restriction of
growth across the forehead leading to a triangular shape
(trigonocephaly) and true narrowing of the orbits
(hypotelorism). It is important to differentiate an isolated
metopic ridge which does not require surgery, from true metopic
synostosis, where surgery is recommended. Surgical therapy for
true metopic synostosis involves a fronto-orbital advancement
which allows for widening the skull at the temporal fossa. This
corrects the abnormal triangular shape