Control of metopic emissary veins in trigonocephaly surgery. Technical note

Introduction Trigonocephaly with its premature fusion of the metopic synostosis is associated with a risk of cerebral compression and several craniofacial morphological deformations. Numerous surgical techniques have been proposed to enlarge and reshape the forehead. They all carry a risk of bleeding during osteotomies, especially in the region of the superior sagittal sinus (SSS) encased in the early fused suture and of the paired metopic transosseous emissary veins superior to the glabella, which is typical of this type of synostosis. In fact, these paired metopic transosseous veins are often, if not always, the source of major bleeding when torn during the elevation of the frontal flap.