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Age at initial consultation for craniosynostosis: comparison across different patient characteristics.
[achondroplasia]
The
severity
and
dysmorphology
that
results
from
the
premature
fusion
of
one
or
more
cranial
sutures
is
not
uniform
.
Less
striking
phenotypes
may
be
more
easily
missed
on
routine
screening
,
possibly
leading
to
delayed
diagnosis
and
treatment
.
The
purpose
of
this
study
was
to
compare
the
age
at
initial
presentation
for
the
different
forms
of
craniosynostosis
.
The
authors
reviewed
the
records
of
all
patients
who
underwent
open
craniofacial
repair
of
craniosynostosis
at
a
single
institution
from
1996
to
2009
.
Relationships
between
type
of
suture
fusion
and
age
at
initial
consultation
were
compared
.
Two
hundred
eleven
patients
(
136
males
,
75
females
)
were
identified
.
Indications
included
sagittal
(
n
=
96
)
,
metopic
(
n
=
39
)
,
unicoronal
(
n
=
33
)
,
bicoronal
(
n
=
24
)
,
multisutural
(
n
=
15
)
,
bilambdoidal
(
n
=
3
)
,
and
unilambdoidal
(
n
=
1
)
synostoses
.
Seventeen
patients
(
8
.
1
%
)
had
a
craniosynostosis
syndrome
and
5
(
2
.
4
%
)
had
a
syndrome
or
disorder
not
typically
associated
with
craniosynostosis
[
X-
linked
hypophosphatemic
rickets
(
n
=
3
)
,
achondroplasia
(
n
=
1
)
,
and
Beckwith
Wiedemann
(
n
=
1
)
]
.
Median
age
at
initial
consultation
was
4
.
1
months
;
there
was
no
gender
difference
.
Patients
with
X-
linked
hypophosphatemic
rickets
presented
at
a
significantly
older
age
than
nonsyndromic
patients
or
those
with
a
known
craniosynostosis
syndrome
.
Those
with
multisutural
synostosis
presented
at
a
significantly
older
age
than
patients
with
sagittal
or
bicoronal
synostosis
.
Patients
with
multisutural
involvement
or
X-
linked
hypophosphatemic
rickets
had
a
significant
delay
in
presentation
for
craniosynostosis
.
The
latter
group
of
patients
may
especially
benefit
from
routine
surveillance
for
craniosynostosis
given
their
advanced
age
at
diagnosis
.
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