Plastic Surgery Research Council

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Normal Metopic Closure Proceeds Similarly Between Different Ethnicities: A Temporal Closure Curve Analysis
Alexander Y. Lin, MD, Kashyap Tadisina, MD.
Saint Louis University School of Medicine, St. Louis, MO, USA.

<PURPOSE:
Normal metopic suture closure was thought to be around 2-years-old until studies demonstrated closure around 7-months-old, ranging from 3-9 months. Further, the progression of morphology is unclear and prior studies have shown differing opinions on thresholds for surgery. Clinically, some have noted that different ethnicities may close at different rates. A pilot study performed by our group found that closure rate was similar between races, but may have been underpowered. We examined metopic closure rates in the first 11 months of life for African-American (AA) and Caucasian (CA) babies.
METHODS:
A retrospective review of non-suture-related head CT scans from 2010-2015 at our academic pediatric hospital was performed. 133 African-American and 133 Caucasian scans from the first 11 months of age were analyzed. The primary outcome measure used was percentage of metopic suture closure. Non- linear regression analysis was performed to develop and compare lines/curves of best fit for each data set.
RESULTS:
266 patients were examined: 133 African American and 133 Caucasian babies. For ages 0-9 months, each month contained at least 10 of each ethnicity. Sutures were classified by percentage of metopic suture closed (Figures 1 and 2). The following findings were made from our data set: All patients had fully open sutures in the first two months of age, not all patients had fully closed sutures by 9 months of age, all patients had fully closed sutures by 11 months of age. Non -linear regression analysis found no statistical difference between AA and CA metopic suture closure curves.
CONCLUSION:
Although it has been suggested that African-American and Caucasian babies may have different temporal closure patterns of the metopic suture, our study shows that overall both groups show a similar rate of normal metopic closure from 0-11 months of age. The temporal closure curve analysis are similar, indicating that normal metopic closure rate is comparable between these groups. This can affect clinical decision-making, such as follow-up timing.


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