Sagittal Ridge Skull Reduction

Q: Dr. Eppley, I am wondering if sagittal ridge skull reduction plus/minus skull augmentation is an option for me. I went to my doctor with this and had an x-ray, head CT, and bone scan done. A surgeon then biopsed this ridge about two months ago. The biopsy showed benign fibroadipose tissue which he tried to take as much of that tissue off as he could. The surgeon also told me the rest of the ridge is bone. I would like to have this extra bone removed so I can achieve a more natural head shape. The ridge measures approximately 7 cm long x 2.5 cm wide x 0.5 cm high. Of note, I have a healing scar from the biopsy that is about 5 cm long that is midline and runs anterior to posterior over the ridge.

A: Your pictures show what appears to be a classic sagittal ridge skull deformity. I have not seen the x-rays but that entire ridge would be expected to be solid bone. I do not know why a ‘biopsy’ was done nor why there would be a sagittal incision of that length for it….but that is past history now. Using that same incision sagittal ridge skull reduction could be down by a bone burring technique. It would be help to see the thickness of the sagittal ridge on the CT scan.

Dr. Barry Eppley

Indianapolis, Indiana