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Studies in Cranial Suture Biology: Regional Dura Mater Determines Overlying Suture Biology

Levine, Jamie P. M.D.; Bradley, James P. M.D.; Roth, Douglas A. M.D.; McCarthy, Joseph G. M.D.; Longaker, Michael T. M.D.

Plastic and Reconstructive Surgery: May 1998 - Volume 101 - Issue 6 - p 1441–1447
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The influence of dura mater on adjacent cranial sutures is significant. By better understanding the mechanisms of normal suture fusion and the role of the dura mater, it may be possible to delineate the events responsible for the premature suture fusion seen in craniosynostosis. In the Sprague-Dawley rat, the posterior frontal suture normally fuses between 12 and 20 days of postnatal life and has proved to be an excellent model to describe normal suture fusion. The purpose of this study was to document the critical role that the dura mater-suture complex may play on cranial suture biology.

Forty Sprague-Dawley rats at 8 days of age were divided into two groups of 20 animals each. The control group (group A) had surgical disruption of the dura matercalvarial interface. This was accomplished by elevating a strip of cranium inclusive of the posterior frontal and sagittal sutures and replacement of the cranial strip back to its anatomic position, all with the dura mater left intact. The experimental group (group B) had the same calvarial elevation (strip craniectomy), but the sutural anatomy/alignment was rotated 180 degrees. This rotation placed the posterior frontal suture into the sagittal suture's anatomic position and the sagittal suture into the posterior frontal suture's anatomic position. All of these procedures were accomplished by leaving the underlying dura mater intact. Animals were killed at 20, 30, 40, and 50 days (12, 22, 32, and 42 days postoperatively), and tissue sections were examined with hematoxylin and eosin staining.

Group A (control) showed normal but delayed suture activity. The posterior frontal suture fused, and the sagittal suture remained patent. Fusion was delayed, not beginning before 20 days (12 days postoperative) and showing complete fusion between 30 and 40 days. Group B (180degree calvarial rotation) demonstrated that the suture in the posterior frontal anatomic position (actual sagittal suture) fused between 20 and 40 days, whereas the suture in the sagittal anatomic position (actual posterior-frontal suture) remained patent throughout the study.

This study demonstrates that the location of the dura mater-suture complex is important in determining either suture patency or closure in this model. Normal closure of the suture overlying the posterior frontal dura mater demonstrates that the dura mater itself, or forces derived in specific cranial locations, determines the overlying suture biology. (Plast. Reconstr. Surg. 101: 1441, 1998.)

Brooklyn and New York, N.Y., and Philadelphia, Pa.

Michael T. Longaker, M.D.

Institute of Reconstructive Plastic Surgery

Laboratory of Developmental Biology and Repair

New York University

550 First Avenue

New York, N.Y. 10016

From the Institute of Reconstructive Plastic Surgery and the Laboratory of Developmental Biology and Repair at the New York University Medical Center. Received for publication December 13, 1996; revised June 19, 1997.

Presented at the 40th Annual Meeting of the Plastic Surgery Research Council in New York, New York, on May 19, 1995.

©1998American Society of Plastic Surgeons