• This is a unique case report of a pediatric patient with ipsilateral lambdoid and coronal craniosynostosis. • It is a valuable report because it represents a nonsyndromic multisuture case, of which only a few have been documented in the medical literature. • The cranial involvement was the patient’s only abnormality, as no additional craniofacial or systemic malformations were found on physical examination. • The report also describes the surgical management and the aesthetic outcomes achieved in this unusual and complex case. Craniosynostosis results from the premature fusion of cranial sutures and represents a severe congenital craniofacial disorder. It may occur as part of a recognized genetic syndrome or as an isolated condition. The most frequent syndromic forms include Apert, Crouzon, Pfeiffer, and Saethre– Chotzen syndromes, which are commonly associated with mutations in the FGFR2 and TWIST1 genes, respectively. Among nonsyndromic variants, sagittal synostosis is the most prevalent single-suture form, while bicoronal fusion is the most frequent presentation when two or more sutures are involved. A 6-month-old female infant presented to the emergency department with a cranial deformity noted since birth, characterized by right frontal and ipsilateral parietal prominence. No additional craniofacial or systemic abnormalities were observed, and both parents were healthy. Imaging studies revealed premature fusion of the left coronal and lambdoid sutures. The patient underwent two staged procedures: initially, bilateral parietooccipital craniotomies with switch cranioplasty, followed by a second surgery consisting of bilateral frontal craniotomies with switch cranioplasty with advancement of the fronto-orbital bar. Postoperative imaging demonstrated satisfactory aesthetic improvement and restoration of cranial vault roundness. Multisuture craniosynostosis represents a complex condition due to the involvement of two or more cranial sutures, warranting evaluation for an underlying genetic syndrome in all cases. Clinical manifestations range from aesthetic and morphological abnormalities to increased intracranial pressure and impaired neurocognitive development. Surgical intervention is often recommended within the first six months of life. Current surgical approaches include traditional open techniques, with a growing trend toward minimally invasive, endoscopy-assisted procedures.
Marco et al. (Sun,) studied this question.