Suture closure in the human chondrocranium: CT assessment.

Abstract

To chronicle the development of ossification centers, sutures, and synchondroses in the chondrocranium throughout childhood by using computed tomography (CT). One hundred eighty-nine children (age range, newborn to 18 years; median age, 4.0 years) without skull base deformity were referred for cranial CT. The closure of 18 sutures and synchondroses was graded. In the occipital bone at birth, six components were identified. The Kerckring ossicle rapidly fused to the supraoccipital bone within the 1st month. At age 1-3 years, the posterior and anterior intraoccipital synchondroses began to fuse. The occipitomastoidal, petro-occipital, and spheno-occipital synchondroses remained partially open into the teenage years. In the sphenoid bone at birth, 13 ossification centers were identified; most assimilated into the sphenoidal body during the first 2 years. Pneumatization of the sphenoid sinus appeared at age 1-2 years and advanced posteriorly over the next 3-5 years. The complex process of skull base development is chronicled, which provides CT standards for judgment of the patterns and timing of sutural or synchondrosal closure.