Examination of the Head, Neck and Eyes

Noonan, Carmel; Rowe, Fiona; Lomax, Anne

doi:10.1002/9781444341928.ch6

Cited by 1 publication

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A proper physical examination of the infant skull should include palpating both anterior and posterior fontanels for patency and assessing bony bridging or beaking along the suture to diagnose craniosynostosis. 14 It is crucial to distinguish craniosynostosis from positional plagiocephaly, a condition in which the soft and malleable head of a baby is molded by the environment. 15 This is usually caused by a preferred sleeping position.…”

Section: Discussionmentioning

confidence: 99%

“…Most often, pediatricians will identify an abnormal head shape and then refer to a tertiary craniofacial team for further assessment. A proper physical examination of the infant skull should include palpating both anterior and posterior fontanels for patency and assessing bony bridging or beaking along the suture to diagnose craniosynostosis 14 . It is crucial to distinguish craniosynostosis from positional plagiocephaly, a condition in which the soft and malleable head of a baby is molded by the environment 15 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can Craniosynostosis be Diagnosed on Physical Examination? A Retrospective Review

Zavala,

Zima,

Greives

et al. 2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Craniosynostosis is a developmental craniofacial defect in which one or more sutures of the skull fuse together prematurely. Uncorrected craniosynostosis may have serious complications including elevated intracranial pressure, developmental delay, and blindness. Proper diagnosis of craniosynostosis requires a physical examination of the head with assessment for symmetry and palpation of sutures for prominence. Often, if craniosynostosis is suspected, computed tomography (CT) imaging will be obtained. Recent literature has posited that this is unnecessary. This study aims to address whether physical examination alone is sufficient for the diagnosis and treatment planning of single suture craniosynostosis. Between 2015 and 2022, the Divisions of Pediatric Neurosurgery and Pediatric Plastic Surgery at UTHealth Houston evaluated 140 children under 36 months of age with suspected craniosynostosis by physical examination and subsequently ordered CT imaging for preoperative planning. Twenty-three patients received a clinical diagnosis of multi-sutural or syndromic craniosynostosis that was confirmed by CT. One hundred seventeen patients were diagnosed with single suture craniosynostosis on clinical examination and follow-up CT confirmed suture fusion in 109 (93.2%) patients and identified intracranial anomalies in 7 (6.0%) patients. These patients underwent surgical correction. Eight (6.8%) patients showed no evidence of craniosynostosis on CT imaging. Treatment for patients without fused sutures included molding helmets and observation alone. This evidence suggests that physical examination alone may be inadequate to accurately diagnose single suture synostosis, and surgery without preoperative CT evaluation could lead to unindicated procedures.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%