Exploring Pediatric Sutural Variations with Three-Dimensional Computed Tomography Imaging: A Retrospective Study at a Tertiary Hospital.

Background: Sutural anatomy variation has long been a topic of debate among anatomists, paleontologists, and morphologists. While the exact reasons for the prevalence of this variance remain a topic of ongoing discussion, developmental and genetic factors are hypothesized to be the main reasons. Understanding the morphology and occurrence of normal sutural variations in pediatric patients is essential to making the right diagnosis, where a misinterpretation of a sutural bone may lead to an inaccurate assessment, completely misleading the diagnostic process.

Methods: This is a retrospective study; we collected the data of the last 100 pediatric patients under the age of 29 months who underwent a three-dimensional (3D) skull computed tomography (CT) for reasons of trauma.

Results: Our study, examining pediatric patients who underwent 3D CT imaging, consisted of 100 children, divided by gender as 52% females and 48% males. The overall mean age of the cohort was 10.04 months. The anterior fontanelle was closed in 28% (n = 28). The posterior fontanelle was closed in 84% with a mean age of 11.57 months (standard deviation=6.24). Notably, all participants had patent coronal, lambdoid, and squamosal sutures (n = 100, 100%) with a mean age of 10.04 months (standard deviation = 6.8). The metopic suture was fused in 70% of the participants (n = 70). A metopic ridge was present in 22% of the participants. Wormian bones were present in 59% (n = 59) of the participants, the majority being on the lambdoid suture. We also observed multiple cranial bone variations among our pediatric patients, including those involving the sphenoparietal suture, sphenofrontal suture, posterior intraoccipital suture, frontozygomatic suture, and mendosal suture.

Conclusions: The current study provides valuable insights into the prevalence and characteristics of skull suture variations in the Saudi pediatric population under the age of one, based on 3D CT imaging data. Our findings indicate a notable occurrence of sutural bone variations, including the presence of Wormian bones and different patterns of suture patency.