Bicoronal synostosis

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The main consequences of Bicoronal synostosis are:

1. Abnormal head shape - Brachycephaly - Flat head shape - The Cranial Index is well above 90, because the biparietal diameter of skull is very high and the AP diameter is short
2. Sloping forehead
3. Harlequin deformity of both eyes
4. Shallow occiput
5. Ridging of both coronal sutures
6. There is a high chance that babies with Bicoronal synostosis can have raised pressure in the brain

Cranial index is the proportion of Bi-parietal diameter (BPD) to the Antero-posterior diameter (APD).

BPD is measured from the widest part of the skull - Side to side.

APD is measured from the longest part of the skull - Front to back

Normal Cranial Index is between 75-85.

Anything below 70 is Scaphocephaly and anything above 90 is Brachycephaly.

Bicoronal synostosis requires surgery for complete correction. Our protocol is as follows:

Non-syndromic

Age below 6 months - Endoscopic strip craniectomy & Orthotic Helmet Therapy

Age above 6 months - Fronto orbital advancement remodelling

Syndromic

Posterior vault expansion using Springs

Fronto orbital advancement remodelling

Timing depends on a case to case basis