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Trigonocephaly

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fronto-supraorbital advancement and remodelling and the 'floating forehead technique' create sufficient space for brain growth and result in a normal horizontal axis of the orbits and supraorbital bar. The fronto-supraorbital advancement and remodelling is the most used method nowadays. Over the past few years distraction osteogenesis has been gradually acknowledged since it has a positive effect on hypotelorism. Expanding the distance between the orbits using springs seems to be successful. However, there are discussions whether hypotelorism really needs to be corrected. The minimal invasive endoscopic surgery has been gaining attention since the early '90s, however, it has technical limitations (only strip craniectomy is possible). Attempts have been made to reach beyond these limits.
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Ardinger, HH; Atkin, JF; Blackston, RD; Elsas, LJ; Clarren, SK; Livingstone, S; Flannery, DB; Pellock, JM; Harrod, MJ; Lammer, Edward J.; Majewski, Frank; Schinzel, Albert; Toriello, Helga V.; Hanson, James W.; Optiz, John M.; Reynolds, James F. (1988). "Verification of the fetal valproate syndrome
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The highest rate of neurological problems of single suture synostosis are seen in patients with trigonocephaly. Surgery is performed generally before the age of one because of claims of better intellectual outcome. Seemingly surgery does not influence the high incidence of neurodevelopment problems
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Men's heads are by no means all like to one another, nor are the sutures of the head of all men constructed in the same form. Thus, whoever has a prominence in the anterior part of the head (by prominence is meant the round protuberant part of the bone which projects beyond the rest of it), in him
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The so-called 'floating forehead technique' combined with the remodelling of the supraorbital bar is derived from the fronto-supraorbital advancement and remodelling. The supraorbital bar is remodelled as described above. The frontal bone is split in two pieces. Instead of using both pieces as in
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The incidence of metopic synostosis is roughly between 1:700 and 1:15,000 newborns globally (differs per country). Trigonocephaly is seen more in males than females ranging from 2:1 to 6.5:1. Hereditary relations in metopic synostosis have been found of which 5.5% were well defined syndromic.
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Wilkie, AO; Bochukova, EG; Hansen, RM; Taylor, IB; Rannan-Eliya, SV; Byren, JC; Wall, SA; Ramos, L; Venâncio, M; Hurst, Jane A.; O'Rourke, Anthony W.; Williams, Louise J.; Seller, Anneke; Lester, Tracy (2007). "Clinical dividends from the molecular genetic diagnosis of craniosynostosis".
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for surgery. Because of standardization of current surgical approaches there is no surgical mortality and complications are few to none. The simple suturectomy is presently insufficient to adjust the complicated growth restrictions caused by metopic synostosis. On the other hand, the
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Via a photo shown on a Facebook page, the mother of a child previously diagnosed with this condition recognised the symptoms and reported them to the family involved, resulting in an immediate diagnosis that medical professionals had overlooked in all earlier consultations.
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after a study of 107 cases of metopic and coronal synostosis. Surgery does not provide a 100% natural outcome, mostly there will be minor irregularities. Reoperations are usually performed on more severe cases (including syndromic metopic synostosis). The
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Van Der Meulen, JJ; Nazir, PR; Mathijssen, IM; Van Adrichem, LN; Ongkosuwito, E; Stolk-Liefferink, SA; Vaandrager, MJ (2008). "Bitemporal depressions after cranioplasty for trigonocephaly: A long-term evaluation of (supra) orbital growth in 92 patients".
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Only one article gives valuable and reliable information regarding the incidence of metopic synostosis in the Netherlands. The incidence in the Netherlands showed an increase from 0.6 (1997) to 1.9 (2007) for every 10,000 live births.
143:. The etiology of trigonocephaly is mostly unknown although there are three main theories. Trigonocephaly is probably a multifactorial congenital condition, but due to limited proof of these theories this cannot safely be concluded. 680:
In former times people born with malformed skulls were rejected based upon their appearance. This still persists today in various parts of the world even though the intellectual development is often normal. The Austrian physician
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Smartt Jr, JM; Karmacharya, J; Gannon, FH; Teixeira, C; Mansfield, K; Hunenko, O; Shapiro, IM; Kirschner, RE (2005). "Intrauterine fetal constraint induces chondrocyte apoptosis and premature ossification of the cranial base".
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Galassi E, Giulioni M, Acciarri N, Cavina C, Pistorale T. Marchac procedure in the early treatment of metopic and coronal synostoses. Presented at the Consensus Conference on Craniosynostoses, Rome 1995.
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in patients with metopic synostosis. Neurological disorders such as ADHD, ASD, ODD and CD are seen in patients with trigonocephaly. These disorders are usually also associated with decreased
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These approaches are 2D solutions for a 3D problem, therefore the results are not optimal. Distraction osteogenesis and minimal invasive endoscopic surgery are yet in experimental phase.
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The first theory assumes that the origin of pathological synostosis lies within disturbed bone formation early on in the pregnancy. Causes can either be genetic (9p22–24, 11q23, 22q11,
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as the main issue behind synostosis. Limited growth of the frontal lobes leads to an absence of stimuli for cranial growth, therefore causing premature fusion of the metopic suture.
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Friede, H; Alberius, P; Lilja, J; Lauritzen, C (1990). "Trigonocephaly: Clinical and cephalometric assessment of craniofacial morphology in operated and nontreated patients".
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Treatment is surgical with attention to form and volume. Surgery usually takes place before the age of one since it has been reported that the intellectual outcome is better.
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Kress, W; Petersen, B; Collmann, H; Grimm, T (2000). "An unusual FGFR1 mutation (fibroblast growth factor receptor 1 mutation) in a girl with non-syndromic trigonocephaly".
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The neuropsychological development is not always affected. These effects are only visible in a small percentage of children with trigonocephaly or other suture synostoses.
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hollowing are the most difficult to correct: the hypotelorism usually remains under corrected and a second operation is often needed for correction of temporal hollowing.
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Sidoti Jr, EJ; Marsh, JL; Marty-Grames, L; Noetzel, MJ (1996). "Long-term studies of metopic synostosis: Frequency of cognitive impairment and behavioral disturbances".
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Maternal age and a birth weight of less than 2500g may also play a role in trigonocephaly. These data are based on estimations and do not give factual information.
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Posnick, JC; Lin, KY; Chen, P; Armstrong, D (1994). "Metopic synostosis: Quantitative assessment of presenting deformity and surgical results based on CT scans".
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fronto-supraorbital advancement and remodelling, only one piece is rotated and attached to the supraorbital bar. This technique also leaves a craniectomy behind.
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Dimopoulos, VG; Machinis, TG; Fountas, KN; Robinson, JS (2005). "Head injury management algorithm as described in Hippocrates' "peri ton en cephali traumaton"".
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Whitaker, LA; Bartlett, SP; Schut, L; Bruce, D (1987). "Craniosynostosis: An analysis of the timing, treatment, and complications in 164 consecutive patients".
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Dirocco, C; Caldarelli, M; Ceddia, A; Iannelli, A; Velardi, F (1989). "Craniostenosis. Analysis of 161 cases surgically treated during the first year of life".
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The simplest form of surgery for trigonocephaly was suturectomy. However, as this technique was insufficient to correct the deformities, it is not used anymore.
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Valentin, M; Ducarme, G; Yver, C; Vuillard, E; Belarbi, N; Renier, D; Luton, D (2008). "Trigonocephaly and valproate: A case report and review of literature".
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Alderman, BW; Fernbach, SK; Greene, C; Mangione, EJ; Ferguson, SW (1997). "Diagnostic practice and the estimated prevalence of craniosynostosis in Colorado".
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Vermeij-Keers, C; Mazzola, RF; Van Der Meulen, JC; Strickler, M (1983). "Cerebro-craniofacial and craniofacial malformations: An embryological analysis".
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Lauritzen, CG; Davis, C; Ivarsson, A; Sanger, C; Hewitt, TD (2008). "The evolving role of springs in craniofacial surgery: The first 100 clinical cases".
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Hoffman, HJ; Mohr, G (1976). "Lateral canthal advancement of the supraorbital margin. A new corrective technique in the treatment of coronal synostosis".
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Distraction osteogenesis is based on creating more cranial space for the brain by gradually moving the bones apart. This can be achieved by using springs.
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McCarthy, JG; Epstein, F; Sadove, M; Grayson, B; Zide, B; McCarthy, Joseph G. (1984). "Early surgery for craniofacial synostosis: An 8-year experience".
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Kapp-Simon, KA; Speltz, ML; Cunningham, ML; Patel, PK; Tomita, T (2007). "Neurodevelopment of children with single suture craniosynostosis: A review".
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Lajeunie, E; Le Merrer, M; Marchac, D; Renier, D (1998). "Syndromal and nonsyndromal primary trigonocephaly: Analysis of a series of 237 patients".
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Strickler M, van der Meulen J, Rahael B, Mazolla R. Craniofacial malformations. Edinburgh, London, Melbourne, New York: Churchill Livingston, 1990.
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Johnsonbaugh, RE; Bryan, RN; Hierlwimmer, R; Georges, LP (1978). "Premature craniosynostosis: A common complication of juvenile thyrotoxicosis".
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without fixation to the cranium. Lastly, the frontal bone is divided into two, rotated and attached to the supraorbital bar causing a nude area (
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Graham Jr, JM; Smith, DW (1980). "Metopic craniostenosis as a consequence of fetal head constraint: Two interesting experiments of nature".
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A form of surgery is the so-called fronto-supraorbital advancement and remodelling. Firstly, the supraorbital bar is remodelled by a wired
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Hinojosa, J; Esparza, J; GarcĂ­a-Recuero, I; Romance, A (2007). "Endoscopically assisted fronto-orbitary correction in trigonocephaly".
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Cohen, SR; Maher, H; Wagner, JD; Dauser, RC; Newman, MH; Muraszko, KM (1994). "Metopic synostosis: Evaluation of aesthetic results".
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Trigonocephaly can either occur in a syndrome or isolated, all by itself. Trigonocephaly is associated with the following syndromes:
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Aryan, HE; Jandial, R; Ozgur, BM; Hughes, SA; Meltzer, HS; Park, MS; Levy, ML (2005). "Surgical correction of metopic synostosis".
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Boulet, SL; Rasmussen, SA; Honein, MA (2008). "A population-based study of craniosynostosis in metropolitan Atlanta, 1989-2003".
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Di Rocco, C; Velardi, F; Ferrario, A; Marchese, E (1996). "Metopic synostosis: In favour of a "simplified" surgical treatment".
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lies underneath (the dura mater has osteogenic capabilities). This results in an advancement and straightening of the forehead.
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Dhellemmes, P; Pellerin, P; Lejeune, JP; Lepoutre, F (1986). "Surgical treatment of trigonocephaly. Experience with 30 cases".
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Kweldam, CF; Van Der Vlugt, JJ; Van Der Meulen, JJ (2010). "The incidence of craniosynostosis in the Netherlands, 1997-2007".
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to straighten it. Secondly, the supraorbital bar is moved 2 cm. forward and fixed only to the frontal process of the
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Akai, Takuya; Iizuka, Hideaki; Kawakami, Shigehiko (2006). "Treatment of craniosynostosis by distraction osteogenesis".
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Delashaw, JB; Persing, JA; Park, TS; Jane, JA (1986). "Surgical approaches for the correction of metopic synostosis".
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Jimenez, DF; Barone, CM (1998). "Endoscopic craniectomy for early surgical correction of sagittal craniosynostosis".
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Hinojosa, J; Esparza, J; Muñoz, MJ (2007). "Endoscopic-assisted osteotomies for the treatment of craniosynostosis".
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Kapp-Simon, KA (1998). "Mental development and learning disorders in children with single suture craniosynostosis".
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Maltese, G; Tarnow, P; Lauritzen, CG (2007). "Spring-assisted correction of hypotelorism in metopic synostosis".
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Oi, S; Matsumoto, S (1987). "Trigonocephaly (metopic synostosis). Clinical, surgical and anatomical concepts".
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Davis, C; Lauritzen, CG (2009). "Frontobasal suture distraction corrects hypotelorism in metopic synostosis".
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Penfold, JL; Simpson, DA (1975). "Premature craniosynostosis-a complication of thyroid replacement therapy".
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Fearon, JA; Kolar, JC; Munro, IR (1996). "Trigonocephaly-associated hypotelorism: Is treatment necessary?".
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teardrop-shaped orbits angulated towards the midline of the forehead ('surprised coon' sign) in severe cases
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Frydman M, Kauschansky A, Elian E. Trigonocephaly; a new familiail syndrome. Am J Med Genet 1984: 18: 55-9.
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Greenberg, BM; Schneider, SJ (2006). "Trigonocephaly: Surgical considerations and long term evaluation".
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Hennekam, RC; Van Den Boogaard, MJ (1990). "Autosomal dominant craniosynostosis of the sutura metopica".
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Frydman, M; Kauschansky, A; Elian, E; Opitz, John M. (1984). "Trigonocephaly: A new familial syndrome".
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Welcker H. Untersugungen uber wachtsum und bau des menschlischen Schädels. Leipzig: Engelmann, 1862.
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Barone, CM; Jimenez, DF (1999). "Endoscopic craniectomy for early correction of craniosynostosis".
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width / maximum cranium length) however, there is bitemporal shortening and biparietal broadening
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Genitori, L; Cavalheiro, S; Lena, G; Dollo, C; Choux, M (1991). "Skull base in trigonocephaly".
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The Anatomy and Physiology of the Nervous System in General, and of the Brain in Particular
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Shillito Jr, J; Matson, DD (1968). "Craniosynostosis: A review of 519 surgical patients".
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Rasmussen, SA; Yazdy, MM; Carmichael, SL; Jamieson, DJ; Canfield, MA; Honein, MA (2007).
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coined the term trigonocephaly in 1862. He described a child with a V-shaped skull and a
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Renier, D; Lajeunie, E; Arnaud, E; Marchac, D (2000). "Management of craniosynostoses".
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The second theory says that synostosis begins when the fetal head gets hindered in the
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a contrast difference between a röntgenograph of a normal and a trigonocephalic skull
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is persistently good with reoperation hazards below 20%. In 1981 Anderson advised
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Meling, TR; Due-Tønnessen, BJ; Helseth, E (2000). "Metotopic craniosynostoses".
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Anderson, FM (1981). "Treatment of coronal and metopic synostosis: 107 cases".
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that craniofacial operations for synostosis should be as extensive as necessary
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Murad, GJ; Clayman, M; Seagle, MB; White, S; Perkins, LA; Pincus, DW (2005).
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together with other abnormalities, or in isolated form. The term is from
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Moss, ML (1959). "The pathogenesis of premature cranial synostosis in man".
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10.1002/(SICI)1096-8628(19980113)75:2<211::AID-AJMG19>3.0.CO;2-S
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Marchac, D (June 1978). "Radical forehead remodeling for craniostenosis".
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Diagnosis can be characterized by typical facial and cranial deformities.
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Collmann, H; Sörensen, N; Krauss, J (1996). "Consensus: Trigonocephaly".
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A. Fronto-supraorbital advancement and remodelling – before remodelling
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B. Fronto-supraorbital advancement and remodelling – after remodelling
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Hippocrates. On injuries of the head. Med classics 1938: 3: 145-60.
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The third theory predominates disturbed brain formation of the two
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Anderson, Frank M; Gwinn, John L; Todt, John C (September 1962).
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the sutures of the head take the form of the Greek letter 'tau',
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a triangular forehead seen from top view leading to a smaller
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Other conditions and syndromes with trigonocephaly include:
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10.1597/1545-1569(1990)027<0362:TCACAO>2.3.CO;2
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10.1597/1545-1569(1998)035<0197:MDALDI>2.3.CO;2
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Journal of Plastic, Reconstructive & Aesthetic Surgery
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Meulen, Jacobus Josephus Nicolaas Marie van der (2009).
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Skull malformation such that the forehead is triangular
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Trigonocephaly seems to be the most compliant form of
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Trigonocephaly in a boy with 1q22–1q23.1 duplication
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Optima Grafische Communicatie. 3110:(6): 1303–5, discussion 1303–5. 2885:10.1097/00006534-199401000-00003 2842:10.1097/00006534-199411000-00002 2799:10.1097/00001665-200605000-00024 2599:10.1097/00006534-199912000-00003 2556:10.1097/00006534-199603000-00001 2294:10.1227/00006123-198608000-00008 2110:10.1097/00006534-197861060-00001 2028:10.1097/00006534-198708000-00006 1936:10.1097/00006534-198404000-00001 1731:10.1097/00006534-199602000-00002 1560:10.1227/00006123-198102000-00001 503: 491: 315:Paris-Trousseau thrombocytopenia 218: 207: 30: 2550:(3): 503–9, discussion 510–11. 228:Trigonocephaly in two cases of 971:Cytogenetics and Cell Genetics 325:Simpson-Golabi-Behmel syndrome 199:Other conditions and syndromes 108:Fused suture in trigonocephaly 1: 1061:10.1016/S0022-3476(78)80493-4 1026:10.1016/S0022-3476(75)80963-2 550:'Floating forehead technique' 448:oppositional defiant disorder 92: 'triangle' and 3161:. 9 May 2012. Archived from 2513:10.1097/SCS.0b013e318190e25d 2210:(4): 362–7, discussion 368. 2177:10.1016/0007-1226(88)90137-3 2064:10.1097/scs.0b013e31815c8a68 1897:10.1016/0007-1226(94)90001-9 300:, primary autosomal dominant 187:Intrinsic brain malformation 116:Trigonocephaly as a kind of 147:Intrinsic bone malformation 3303: 3082:http://www.phrenology.org/ 3033:10.1016/j.bjps.2010.08.026 2710:10.3171/jns.1998.88.1.0077 2259:10.3171/jns.1976.45.4.0376 1467:10.3171/jns.1962.19.9.0723 475:Excessive citations inline 2753:10.1007/s00381-007-0473-8 1645:10.1007/s00381-004-1108-y 1419:10.1007/s00381-006-0251-z 1088:Obstetrics and Gynecology 1049:The Journal of Pediatrics 1014:The Journal of Pediatrics 685:presented the science of 38: 29: 3056:The Cleft Palate Journal 811:Human Molecular Genetics 577:Distraction osteogenesis 452:autism spectrum disorder 309:Orofaciodigital syndrome 2698:Journal of Neurosurgery 2666:10.3171/foc.2005.19.6.7 2247:Journal of Neurosurgery 1454:Journal of Neurosurgery 1227:10.1002/ajmg.1320290123 905:10.1002/ajmg.1320180109 480:considered for deletion 320:Potocki-Lupski syndrome 2943:Pediatric Neurosurgery 2741:Child's Nervous System 2363:Child's Nervous System 2317:Pediatric Neurosurgery 1970:Child's Nervous System 1834:Child's Nervous System 1676:Child's Nervous System 1633:Child's Nervous System 1590:Child's Nervous System 1407:Child's Nervous System 1262:10.1542/peds.65.5.1000 585: 573: 359:anterior cranial fossa 264:Bohring-Opitz syndrome 253:glycine encephalopathy 155:mutation), metabolic ( 137:Baller–Gerold syndrome 125:Bohring-Opitz syndrome 120: 109: 1982:10.1007/s003810000320 1508:10.1542/peds.41.4.829 824:10.1093/hmg/6.10.1647 304:Mucolipidosis type II 269:Coffin-Siris syndrome 175:Fetal-head constraint 163:) or pharmaceutical ( 115: 107: 2990:10.1002/ajmg.a.32208 861:10.1002/ajmg.a.31905 379:Imaging techniques ( 2653:Neurosurgical Focus 805:Wilkie, AO (1997). 524:greenstick fracture 331:Trichothiodystrophy 2622:Cirugia Pediatrica 2375:10.1007/BF00366147 1846:10.1007/BF00272491 1802:Minerva Pediatrica 1688:10.1007/BF00271819 1602:10.1007/BF00366148 1171:Prenatal Diagnosis 1094:(2 Pt 1): 369–77. 439:mental retardation 430:Neuropsychological 293:Carpenter syndrome 141:Say–Meyer syndrome 121: 110: 3274: 3273: 2955:10.1159/000120591 2329:10.1159/000094064 1976:(10–11): 645–58. 1384:10.1159/000141479 983:10.1159/000056834 928:Clinical Genetics 791:978-90-8559-601-1 782:On trigonocephaly 683:Franz Joseph Gall 279:Holoprosencephaly 133:Jacobsen syndrome 55: 54: 19:Medical condition 3294: 3187: 3175: 3174: 3172: 3170: 3151: 3145: 3142: 3136: 3135: 3099: 3093: 3090: 3084: 3078: 3072: 3071: 3051: 3045: 3044: 3016: 3010: 3009: 2973: 2967: 2966: 2938: 2932: 2931: 2903: 2897: 2896: 2868: 2862: 2861: 2825: 2819: 2818: 2782: 2773: 2772: 2736: 2730: 2729: 2693: 2687: 2686: 2668: 2644: 2638: 2637: 2617: 2611: 2610: 2582: 2576: 2575: 2539: 2533: 2532: 2496: 2490: 2489: 2453: 2447: 2446: 2410: 2404: 2401: 2395: 2394: 2358: 2349: 2348: 2312: 2306: 2305: 2277: 2271: 2270: 2242: 2236: 2235: 2199: 2190: 2189: 2179: 2155: 2149: 2148: 2128: 2122: 2121: 2093: 2084: 2083: 2046: 2040: 2039: 2011: 2002: 2001: 1965: 1956: 1955: 1919: 1910: 1909: 1899: 1875: 1866: 1865: 1829: 1818: 1817: 1797: 1786: 1785: 1757: 1751: 1750: 1714: 1708: 1707: 1671: 1665: 1664: 1628: 1622: 1621: 1585: 1572: 1571: 1543: 1528: 1527: 1491: 1480: 1479: 1469: 1445: 1439: 1438: 1402: 1396: 1395: 1367: 1361: 1360: 1349:10.1148/68.6.863 1332: 1326: 1325: 1288: 1282: 1281: 1245: 1239: 1238: 1209: 1203: 1202: 1166: 1160: 1159: 1131: 1120: 1119: 1079: 1073: 1072: 1044: 1038: 1037: 1009: 1003: 1002: 966: 960: 959: 923: 917: 916: 887: 881: 880: 843: 837: 836: 826: 802: 796: 795: 777: 746: 743: 609:craniosynostosis 507: 495: 483: 456:conduct disorder 398:in limited cases 396:epicanthal folds 222: 211: 118:craniosynostosis 50:Medical genetics 34: 22: 3302: 3301: 3297: 3296: 3295: 3293: 3292: 3291: 3277: 3276: 3275: 3270: 3269: 3198: 3184: 3179: 3178: 3168: 3166: 3165:on 11 June 2012 3153: 3152: 3148: 3143: 3139: 3101: 3100: 3096: 3091: 3087: 3079: 3075: 3053: 3052: 3048: 3018: 3017: 3013: 2975: 2974: 2970: 2940: 2939: 2935: 2905: 2904: 2900: 2870: 2869: 2865: 2830:Plastic Surgery 2827: 2826: 2822: 2784: 2783: 2776: 2747:(12): 1421–30. 2738: 2737: 2733: 2695: 2694: 2690: 2646: 2645: 2641: 2619: 2618: 2614: 2584: 2583: 2579: 2541: 2540: 2536: 2498: 2497: 2493: 2455: 2454: 2450: 2412: 2411: 2407: 2402: 2398: 2360: 2359: 2352: 2314: 2313: 2309: 2279: 2278: 2274: 2244: 2243: 2239: 2201: 2200: 2193: 2157: 2156: 2152: 2139:(26): 3147–50. 2130: 2129: 2125: 2095: 2094: 2087: 2048: 2047: 2043: 2013: 2012: 2005: 1967: 1966: 1959: 1921: 1920: 1913: 1877: 1876: 1869: 1831: 1830: 1821: 1799: 1798: 1789: 1759: 1758: 1754: 1716: 1715: 1711: 1673: 1672: 1668: 1630: 1629: 1625: 1587: 1586: 1575: 1545: 1544: 1531: 1493: 1492: 1483: 1447: 1446: 1442: 1404: 1403: 1399: 1369: 1368: 1364: 1334: 1333: 1329: 1290: 1289: 1285: 1247: 1246: 1242: 1211: 1210: 1206: 1183:10.1002/pd.1948 1168: 1167: 1163: 1133: 1132: 1123: 1081: 1080: 1076: 1046: 1045: 1041: 1011: 1010: 1006: 977:(1–4): 138–40. 968: 967: 963: 925: 924: 920: 890: 888: 884: 845: 844: 840: 817:(10): 1647–56. 804: 803: 799: 792: 779: 778: 749: 744: 737: 732: 723: 721:Popular culture 711:Hermann Welcker 678: 665: 652: 618: 605: 600: 561: 552: 520: 515: 514: 513: 512: 511: 508: 500: 499: 496: 468: 465: 348: 235: 234: 233: 232: 225: 224: 223: 214: 213: 212: 201: 189: 177: 149: 129:Muenke syndrome 102: 20: 17: 12: 11: 5: 3300: 3298: 3290: 3289: 3279: 3278: 3272: 3271: 3268: 3267: 3256: 3245: 3230: 3215: 3199: 3194: 3193: 3191: 3190:Classification 3183: 3182:External links 3180: 3177: 3176: 3146: 3137: 3094: 3085: 3073: 3046: 3027:(5): 583–588. 3011: 2968: 2933: 2898: 2863: 2820: 2774: 2731: 2688: 2639: 2612: 2577: 2534: 2491: 2448: 2405: 2396: 2369:(11): 654–63. 2350: 2307: 2272: 2237: 2191: 2150: 2123: 2085: 2041: 2022:(2): 195–212. 2003: 1957: 1911: 1867: 1819: 1808:(8): 393–404. 1787: 1768:(3): 197–203. 1752: 1709: 1666: 1623: 1573: 1529: 1481: 1440: 1397: 1372:Acta Anatomica 1362: 1327: 1283: 1240: 1204: 1161: 1121: 1074: 1039: 1004: 961: 918: 882: 855:(16): 1941–9. 838: 797: 790: 747: 734: 733: 731: 728: 722: 719: 677: 674: 664: 661: 651: 648: 617: 614: 604: 601: 599: 596: 592: 591: 580: 579: 568: 567: 560: 557: 551: 548: 534:) between the 519: 516: 509: 502: 501: 497: 490: 489: 488: 487: 486: 464: 461: 460: 459: 440: 437: 424: 423: 416:cephalic index 412: 405: 402: 399: 385:Röntgenography 377: 376: 364: 361: 347: 344: 343: 342: 337: 335:photosensitive 328: 322: 317: 312: 306: 301: 295: 286: 281: 276: 271: 266: 261: 260:, Verloes type 255: 249: 242:Arthrogryposis 227: 226: 217: 216: 215: 206: 205: 204: 203: 202: 200: 197: 188: 185: 183:during birth. 176: 173: 161:hypothyroidism 159:suppletion in 148: 145: 101: 98: 96: 'head'. 66:metopic suture 58:Trigonocephaly 53: 52: 47: 41: 40: 36: 35: 27: 26: 25:Trigonocephaly 18: 15: 13: 10: 9: 6: 4: 3: 2: 3299: 3288: 3285: 3284: 3282: 3266: 3262: 3261: 3257: 3255: 3251: 3250: 3246: 3244: 3240: 3239: 3235: 3231: 3229: 3225: 3224: 3220: 3216: 3214: 3210: 3209: 3205: 3201: 3200: 3197: 3192: 3188: 3181: 3164: 3160: 3156: 3150: 3147: 3141: 3138: 3133: 3129: 3125: 3121: 3117: 3113: 3109: 3105: 3098: 3095: 3089: 3086: 3083: 3077: 3074: 3069: 3065: 3062:(2): 128–45. 3061: 3057: 3050: 3047: 3042: 3038: 3034: 3030: 3026: 3022: 3015: 3012: 3007: 3003: 2999: 2995: 2991: 2987: 2984:(8): 984–91. 2983: 2979: 2972: 2969: 2964: 2960: 2956: 2952: 2949:(4): 175–81. 2948: 2944: 2937: 2934: 2929: 2925: 2921: 2917: 2914:(2): 159–64. 2913: 2909: 2902: 2899: 2894: 2890: 2886: 2882: 2878: 2874: 2867: 2864: 2859: 2855: 2851: 2847: 2843: 2839: 2836:(6): 759–67. 2835: 2831: 2824: 2821: 2816: 2812: 2808: 2804: 2800: 2796: 2793:(3): 528–35. 2792: 2788: 2781: 2779: 2775: 2770: 2766: 2762: 2758: 2754: 2750: 2746: 2742: 2735: 2732: 2727: 2723: 2719: 2715: 2711: 2707: 2703: 2699: 2692: 2689: 2684: 2680: 2676: 2672: 2667: 2662: 2658: 2654: 2650: 2643: 2640: 2635: 2631: 2627: 2623: 2616: 2613: 2608: 2604: 2600: 2596: 2592: 2588: 2581: 2578: 2573: 2569: 2565: 2561: 2557: 2553: 2549: 2545: 2538: 2535: 2530: 2526: 2522: 2518: 2514: 2510: 2506: 2502: 2495: 2492: 2487: 2483: 2479: 2475: 2471: 2467: 2464:(3): 977–84. 2463: 2459: 2452: 2449: 2444: 2440: 2436: 2432: 2428: 2424: 2421:(2): 545–54. 2420: 2416: 2409: 2406: 2400: 2397: 2392: 2388: 2384: 2380: 2376: 2372: 2368: 2364: 2357: 2355: 2351: 2346: 2342: 2338: 2334: 2330: 2326: 2323:(5): 288–92. 2322: 2318: 2311: 2308: 2303: 2299: 2295: 2291: 2288:(2): 228–34. 2287: 2283: 2276: 2273: 2268: 2264: 2260: 2256: 2253:(4): 376–81. 2252: 2248: 2241: 2238: 2233: 2229: 2225: 2221: 2217: 2213: 2209: 2205: 2198: 2196: 2192: 2187: 2183: 2178: 2173: 2169: 2165: 2161: 2154: 2151: 2146: 2142: 2138: 2134: 2127: 2124: 2119: 2115: 2111: 2107: 2104:(6): 823–35. 2103: 2099: 2092: 2090: 2086: 2081: 2077: 2073: 2069: 2065: 2061: 2057: 2053: 2045: 2042: 2037: 2033: 2029: 2025: 2021: 2017: 2010: 2008: 2004: 1999: 1995: 1991: 1987: 1983: 1979: 1975: 1971: 1964: 1962: 1958: 1953: 1949: 1945: 1941: 1937: 1933: 1930:(4): 521–33. 1929: 1925: 1918: 1916: 1912: 1907: 1903: 1898: 1893: 1890:(4): 211–22. 1889: 1885: 1881: 1874: 1872: 1868: 1863: 1859: 1855: 1851: 1847: 1843: 1840:(5): 228–32. 1839: 1835: 1828: 1826: 1824: 1820: 1815: 1811: 1807: 1803: 1796: 1794: 1792: 1788: 1783: 1779: 1775: 1771: 1767: 1763: 1756: 1753: 1748: 1744: 1740: 1736: 1732: 1728: 1725:(2): 276–81. 1724: 1720: 1713: 1710: 1705: 1701: 1697: 1693: 1689: 1685: 1682:(5): 259–65. 1681: 1677: 1670: 1667: 1662: 1658: 1654: 1650: 1646: 1642: 1638: 1634: 1627: 1624: 1619: 1615: 1611: 1607: 1603: 1599: 1596:(11): 664–8. 1595: 1591: 1584: 1582: 1580: 1578: 1574: 1569: 1565: 1561: 1557: 1553: 1549: 1542: 1540: 1538: 1536: 1534: 1530: 1525: 1521: 1517: 1513: 1509: 1505: 1502:(4): 829–53. 1501: 1497: 1490: 1488: 1486: 1482: 1477: 1473: 1468: 1463: 1460:(9): 723–30. 1459: 1455: 1451: 1444: 1441: 1436: 1432: 1428: 1424: 1420: 1416: 1413:(3): 269–81. 1412: 1408: 1401: 1398: 1393: 1389: 1385: 1381: 1378:(4): 351–70. 1377: 1373: 1366: 1363: 1358: 1354: 1350: 1346: 1342: 1338: 1331: 1328: 1323: 1319: 1315: 1311: 1307: 1303: 1300:(5): 1363–9. 1299: 1295: 1287: 1284: 1279: 1275: 1271: 1267: 1263: 1259: 1256:(5): 1000–2. 1255: 1251: 1244: 1241: 1236: 1232: 1228: 1224: 1221:(1): 171–85. 1220: 1216: 1208: 1205: 1200: 1196: 1192: 1188: 1184: 1180: 1177:(3): 259–61. 1176: 1172: 1165: 1162: 1157: 1153: 1149: 1145: 1141: 1137: 1130: 1128: 1126: 1122: 1117: 1113: 1109: 1105: 1101: 1097: 1093: 1089: 1085: 1078: 1075: 1070: 1066: 1062: 1058: 1055:(2): 188–91. 1054: 1050: 1043: 1040: 1035: 1031: 1027: 1023: 1019: 1015: 1008: 1005: 1000: 996: 992: 988: 984: 980: 976: 972: 965: 962: 957: 953: 949: 945: 941: 937: 933: 929: 922: 919: 914: 910: 906: 902: 898: 894: 886: 883: 878: 874: 870: 866: 862: 858: 854: 850: 842: 839: 834: 830: 825: 820: 816: 812: 808: 801: 798: 793: 787: 783: 776: 774: 772: 770: 768: 766: 764: 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67: 63: 59: 51: 48: 46: 42: 37: 33: 28: 23: 3258: 3247: 3232: 3217: 3202: 3167:. Retrieved 3163:the original 3158: 3149: 3140: 3107: 3104:Neurosurgery 3103: 3097: 3088: 3080:Phrenology. 3076: 3059: 3055: 3049: 3024: 3020: 3014: 2981: 2977: 2971: 2946: 2942: 2936: 2911: 2907: 2901: 2879:(1): 16–24. 2876: 2872: 2866: 2833: 2829: 2823: 2790: 2786: 2744: 2740: 2734: 2704:(1): 77–81. 2701: 2697: 2691: 2656: 2652: 2642: 2625: 2621: 2615: 2590: 2586: 2580: 2547: 2543: 2537: 2507:(1): 121–4. 2504: 2500: 2494: 2461: 2457: 2451: 2418: 2414: 2408: 2399: 2366: 2362: 2320: 2316: 2310: 2285: 2282:Neurosurgery 2281: 2275: 2250: 2246: 2240: 2207: 2203: 2167: 2163: 2153: 2136: 2132: 2126: 2101: 2097: 2055: 2051: 2044: 2019: 2015: 1973: 1969: 1927: 1923: 1887: 1883: 1837: 1833: 1805: 1801: 1765: 1761: 1755: 1722: 1718: 1712: 1679: 1675: 1669: 1639:(5): 392–8. 1636: 1632: 1626: 1593: 1589: 1554:(2): 143–9. 1551: 1548:Neurosurgery 1547: 1499: 1495: 1457: 1453: 1443: 1410: 1406: 1400: 1375: 1371: 1365: 1343:(6): 863–5. 1340: 1336: 1330: 1297: 1293: 1286: 1253: 1249: 1243: 1218: 1214: 1213:phenotype". 1207: 1174: 1170: 1164: 1142:(2): 211–5. 1139: 1135: 1091: 1087: 1077: 1052: 1048: 1042: 1020:(3): 360–3. 1017: 1013: 1007: 974: 970: 964: 934:(5): 374–7. 931: 927: 921: 896: 892: 885: 852: 848: 841: 814: 810: 800: 781: 724: 709: 700: 695: 690: 679: 670: 666: 663:Epidemiology 653: 650:Neurological 640:hypotelorism 634: 619: 606: 593: 582: 570: 553: 540:frontal bone 521: 473: 466: 428: 425: 378: 367:hypotelorism 352: 349: 298:Microcephaly 246:cleft palate 236: 230:microcephaly 190: 178: 150: 122: 93: 89: 73: 57: 56: 3159:News.com.au 2628:(1): 33–8. 2170:(1): 1–15. 2058:(1): 72–9. 899:(1): 55–9. 697:Hippocrates 623:outcome of 565:Suturectomy 532:craniectomy 454:(ASD), and 432:signs are: 3260:DiseasesDB 1496:Pediatrics 1250:Pediatrics 730:References 687:phrenology 628:synostosis 544:dura mater 374:hypoplasia 68:(from 2659:(6): E6. 1337:Radiology 1199:206345527 715:cleft lip 621:Aesthetic 616:Aesthetic 478:is being 463:Treatment 418:(maximum 414:a normal 371:ethmoidal 369:inducing 346:Diagnosis 291:-related 251:Atypical 165:valproate 45:Specialty 3281:Category 3132:26216660 3124:16331180 3041:20888312 3006:33500062 2998:18344207 2858:21873862 2815:13150853 2807:16770193 2761:17899127 2726:36281056 2683:18876090 2675:16398483 2634:17489491 2607:11149758 2572:19640552 2521:19165007 2486:42309644 2478:17312504 2443:24667119 2435:18300975 2391:12026358 2345:31884062 2337:16902340 2232:39803020 2145:11109361 2080:41247691 2072:18216668 1998:22876385 1990:11151714 1952:19795497 1862:44728949 1747:24545701 1704:11548878 1661:22517024 1653:15714353 1618:32346174 1476:13861226 1435:29722887 1427:17186250 1392:14424622 1357:13441914 1322:23430674 1314:16217480 1278:27668507 1191:18264949 1116:28956479 1108:17666613 999:37239155 991:11173846 956:27026160 877:35697095 869:17621648 644:temporal 603:Surgical 598:Outcomes 471:template 446:(ADHD), 391:) show: 169:epilepsy 90:trigonon 82:syndrome 78:forehead 3213:LB70.0Y 3068:6406099 2963:1822130 2928:9041871 2893:8278471 2850:7972420 2769:9318496 2718:9420076 2564:8596780 2383:9118127 2302:3748350 2224:2253382 2186:3345401 2036:3602170 1944:6709733 1906:8081607 1854:3791279 1814:2601658 1782:9603552 1739:8559809 1696:3427566 1610:9118128 1568:7207779 1524:2187741 1516:5643989 1270:7367110 1235:3125743 1156:9450889 1034:1113223 948:2282717 913:6741996 833:9300656 676:History 631:surgery 625:metopic 484:  450:(ODD), 420:cranium 409:lateral 311:type 14 94:kephale 76: ' 74:metopon 64:of the 3254:190440 3169:31 May 3130:  3122:  3066:  3039:  3004:  2996:  2961:  2926:  2891:  2856:  2848:  2813:  2805:  2767:  2759:  2724:  2716:  2681:  2673:  2632:  2605:  2570:  2562:  2529:111447 2527:  2519:  2484:  2476:  2441:  2433:  2389:  2381:  2343:  2335:  2300:  2267:956873 2265:  2230:  2222:  2184:  2143:  2118:662945 2116:  2078:  2070:  2034:  1996:  1988:  1950:  1942:  1904:  1860:  1852:  1812:  1780:  1745:  1737:  1702:  1694:  1659:  1651:  1616:  1608:  1566:  1522:  1514:  1474:  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Index


Specialty
Medical genetics
fusion
metopic suture
Ancient Greek
forehead
syndrome
Ancient Greek


craniosynostosis
Bohring-Opitz syndrome
Muenke syndrome
Jacobsen syndrome
Baller–Gerold syndrome
Say–Meyer syndrome
FGFR1
TSH
hypothyroidism
valproate
epilepsy
pelvic outlet
frontal lobes
male
female
microcephaly
Arthrogryposis
cleft palate
glycine encephalopathy

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