Wormian bones and nonsyndromic craniosynostosis: A comparative study using computed tomography

Introduction: Wormian bones (WB) are accessory bones positioned within the sutures or fontanelles. Although several studies have associated them with genetic disorders, ethnicity, and skull deformations, their relationship with nonsyndromic craniosynostosis (CS) has not been established, especially among Brazilians. Therefore, this study was conducted to analyze the incidence and association of WB with nonsyndromic CS in Brazilian children. Methods: An observational and retrospective study was conducted using computed tomography with 3D reconstruction in Brazilian children aged <3 years to compare the incidence and number of WB between regular children (group 1) and those with nonsyndromic CS (group 2). Results: A total of 140 children, comprising 62.9% boys (p < 0.001) with a mean age of 8.78 months, were included in this study. The most common types of CS were trigonocephaly (34; 48.6%), scaphocephaly (25; 35.7%), anterior plagiocephaly (5; 7.1%), posterior plagiocephaly (3; 4.2%), and brachycephaly (3; 4.2%). WB were more common in regular children (41; 58.6%) than in children with CS (28; 40.0%) (p = 0.028). Regular children had an average of 2.12 WB versus 1.32 WB in children with nonsyndromic CS (p = 0.024). Conclusion: The significantly less incidence of WB in Brazilian children with nonsyndromic CS was quite different from that reported in other studies and could indicate the tendency of this disease to have disturbance in ossification of the cranial vault, the impact of ethnicity, and probably the lack of additional compensatory skull growth.