Definition of topographic organization of skull profile In normal population and its implication on the role of sutures in skull morphology

ObjectivesThe geometric configuration of skull is complex and unique to each individual. The main objectives of this study are two fold: 1) to provide a new technique to define the outline of skull profile and 2) to find the common factors defining the ultimate skull configuration in adult population. The secondary objective was to explore the effect of age and sex on skull shape formation.Materials & Methods Ninety-three lateral skull x-ray from the CT scan films were selected and digitized. The lateral skull surface was divided into 3 regions based on the presumed location of coronal and lambdoid sutures. A software program (Canvas 7) was used to match the outer surface of lateral skull with circular curves. Three main curvatures (frontal, parietal, occipital) were consistently identified to overlap the skull periphery. The radius, cord length and inclination of each curvature were measured.. Factor analysis technique was also used to reduce the number of variables explaining the overall shape of skull. Student t-test and regression analysis was also used to explore the effect of sex and age on skull shape. Results There were total of 93 patients in this study (54% male). The average values for three defined curvatures of the skull profile were recorded. Factor analysis produced 3 factors. The first factor explained 32% of total variance and was related to the overall size of the head as represented by total length and the radius of the curvature in vertex and back of the head. The second factor covered 26% of the variance representing the inverse correlation between the angle of the frontal and parietal curves. The third factor revealed the direct correlation of occipital and parietal angle. In all of these factors, the frontal zone variation was independent or opposite of the parieto-occipital zone. A strong direct association between the total length of skull, occipital curve radius and length with the sex was shown. No age related variable was identified.Conclusions There is a large variation in the values of different part of the skull. The skull profile topography can be defined mathematically by two distinct territories: frontal and parieto-occipital zones. These territories hinge on the coronal suture. Therefore, coronal suture may play a dominant role in final skull configuration