Metopic ridge

A benign metopic ridge presents itself as a slight or noticeable ridge in the metopic suture (also called frontal suture), that is running down the middle of a child's forehead. The child otherwise has a mostly normally shaped forehead and head. A metopic ridge is usually a benign and isolated finding. In most cases, a metopic ridge does not affect brain development or cause any functional issues. Usually the child does not show any abnormal mood or general condition like crying a lot or showing prolonged discomfort, and is perceived as present and normal. == Causes ==

Metopic ridges are usually caused by a birth defect called craniosynostosis, more specifically metopic synostosis, but can also be associated with other congenital skeletal defects. Both metopic ridge and trigonocephaly involve premature fusion of the metopic suture. Like with trigonocephaly, there is no single proven cause for metopic ridge, and there is often no identifiable reason. == Diagnosis ==

In metopic ridge the fusion is not severe enough to cause significant changes in the shape of the skull except a slight bulge along the metopic ridge. It is often differentiated from trigonocephaly, which is more serious, affects the shape of the forehead and head more, and requires medical intervention to avoid danger of significant impact on the child's brain development. Early diagnosis is beneficial, since surgery for trigonocephaly can be done endoscopic between 4 and 6 months, or as open surgery between 6 and 12 months. After about 12 months of age the skull (like the skeleton in the rest of the body) hardens, and becomes less malleable, and decreases its tendency to close any open sutures after surgery (even though it still has a much higher likelihood of closing compared to an adult). == Treatment ==

Benign metopic ridge usually does not require treatment. Surgical intervention is not needed for benign metopic ridge, however it is needed if the diagnose is trigonocephaly. Non-surgical options are generally limited. Methods such as molding via helmet therapy for shaping a baby's head over time is not commonly used for benign metopic ridge, but is used for plagiocephaly, brachycephaly or scaphocephaly. == Prognosis ==

The metopic ridges may become less cosmetically prominent during the first few years of life as the head grows and facial features develop. How much a metopic ridge flattens out and when can vary from child to child. It can be monitored over time with regular check-ups with a pediatrician. By the time a child reaches the age of about 6 years the ridge might be significantly less noticeable or even barely detectable. In some cases the ridge can remain prominent into adulthood, which can cause concern in patients about appearance (not to be confused with persistent metopic suture). == Epidemiology ==

"Benign metopic ridge from a normal physiological of closure can be present in 10–25% of infants (Cohen and MacLean, 2000)". == See also ==