E

Fig. 25.4. Bilateral coronal synostosis. a Primary pathology and compensatory changes. b Bi-fronto-parietal and parieto-occipital craniotomies. c Orbital rim reconstruction. d Vault reconstruction. e Reconstruction of vault.

(Fig. 25.1). Anterior fusion causes excessive growth at the coronal and metopic sutures, resulting in varying degrees of frontal bossing.

Likewise, posterior sagittal synostosis causes varying degrees of deformity in the occipital bone. Closure of the posterior portion of the sagittal suture occurs less commonly and requires different surgical approaches. There are several variants, each demanding individual consideration. The most basic deformity is the so-called occipital knob. In such a circumstance, the occipital bone, because it is distal and perpendicular to the fused suture, experiences the compensatory overgrowth. The "golf tee" deformity is more than simply an exaggerated form of the occipital knob. The skull is narrower posteriorly and protrudes more prominently. In addition, the unfused anterior portion of the sagittal suture can widen the parietal bone anteriorly, accentuating the occipital narrowing. Bathrocephaly - another variant of posterior sagittal synostosis - is characterized by the appearance of a podium in the occipital region. The posterior portion of the parietal

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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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