Lastly, the frontal bone is divided into two, rotated and attached to the supraorbital bar causing a nude area (craniectomy) between the parietal bone and frontal bone. Bone will eventually regenerate since the dura mater lies underneath (the dura mater has osteogenic capabilities). This results in an advancement and straightening of the forehead. Floating forehead technique
The so-called floating forehead technique combined with the remodelling of the supraorbital bar is derived from the fronto-supraorbital advancement and remodelling. The supraorbital bar is remodelled as described above. The frontal bone is split in two pieces. Instead of using both pieces as in fronto-supraorbital advancement and remodelling, only one piece is rotated and attached to the supraorbital bar. This technique also leaves a craniectomy behind. Other
SuturectomyThe simplest form of surgery for trigonocephaly was suturectomy. However, as this technique was insufficient to correct the deformities, it is not used anymore. Distraction osteogenesisDistraction osteogenesis is based on creating more cranial space for the brain by gradually moving the bones apart. This can be achieved by using springs. Minimal invasive endoscopic surgeryThese approaches are 2D solutions for a 3D problem, therefore the results are not optimal. Distraction osteogenesis and minimal invasive endoscopic surgery are yet in experimental phase. Outcomes
Surgical
Trigonocephaly seems to be the most compliant form of craniosynostosis for surgery. Because of standardization of current surgical approaches there is no surgical mortality and complications are few to none. The simple suturectomy is presently insufficient to adjust the complicated growth restrictions caused by metopic synostosis.
The Austrian physician Franz Joseph Gall presented the science of phrenology in the early 19th century through his work The Anatomy and Physiology of the Nervous System in General, and of the Brain in Particular.Hippocrates described trigonocephaly as follows: Mens heads are by no means all like to one another, nor are the sutures of the head of all men constructed in the same form. Thus, whoever has a prominence in the anterior part of the head (by prominence is meant the round protuberant part of the bone which projects beyond the rest of it), in him the sutures of the head take the form of the Greek letter tau, τ.Hermann Welcker coined the term trigonocephaly in 1862. He described a child with a V-shaped skull and a cleft lip. Popular culture
Via a photo shown on a Facebook page, the mother of a child previously diagnosed with this condition recognised the symptoms and reported them to the family involved, resulting in an immediate diagnosis that medical professionals had overlooked in all earlier consultations. References


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