Cranial sutures: a multidisciplinary review.

INTRODUCTION: Progress in cranial suture research is shaping our current understanding of the topic; however, emphasis has been placed on individual contributing components rather than the cranial sutural system as a whole. Improving our holistic view helps further guide clinicians who treat cranial sutural abnormalities as well as researchers who study them. MATERIALS AND METHODS: Information from anatomy, anthropology, surgery, and computed modeling was integrated to provide a perspective to interpret suture formation and variability within the cranial functional and structural system. RESULTS: Evidence from experimental settings, simulations, and evolution suggest a multifactorial morphogenetic process associated with functions and morphology of the sutures. Despite molecular influences, the biomechanical cranial environment has a main role in both the ontogenetic and phylogenetic suture dynamics. CONCLUSIONS: Furthering our holistic understanding of the intricate cranial sutural system promises to expand our knowledge and enhance our ability to treat associated anomalies.

[Cranial osteopathy as a complementary treatment of postural plagiocephaly]. / Place de l'ostéopathie dans la correction des déformations crâniennes du nouveau-né et du jeune enfant.

For the majority of neonates and young infants, appropriate postures and standard physiotherapy succeed in preventing or correcting acquired cranial deformations (fetal due to restricted mobility in utero or postnatal secondary to exclusive dorsal decubitus). However in some cases, when postural management is not efficient, pediatricians will be asked by the parents about the potential benefits of osteopathy. What is osteopathic treatment? At first, diagnostic palpation will identify which suture is normally mobile with the respiratory cycle, and which has limited or absent mobility secondary to abnormal postures. Later on, the goal of the therapeutic phase is to mobilise impaired sutures, by various gentle maneuvers depending on the topography of the impairment. The treatment is not restricted to the skull but extended to the spine, pelvis and lower extremities which contribute to the deformative sequence. Osteopathic treatment belongs to complementary medicine, therefore demonstration of its scientific value and favorable results have to be provided. Based on randomized studies, the answer is yes, it significantly decreases the degree of asymmetry. Do postural deformations matter to the development of an healthy infant? It seems that the prejudice is not only esthetic but also functional, however more research is necessary. In conclusion, pediatricians should be more aware of the method and expectations: major deformative sequence since birth and increasing deformations despite preventive postures and standard physiotherapy are reasonable indications for such complementary treatment. "Preventive" osteopathy in maternity is not justified. Moreover osteopathy has no place in the treatment of craniosynostosis ; the latter belong to malformations, completely distinct from postural deformations.

Pruebas científicas de la movilidad del cráneo / Scientific test of cranial mobility

La osteopatía craneal no debe ser basada sobre el misticismo; el famoso movimiento respiratorio primario (MRP) no existe. Las pruebas científicas demostrando que existe un micromovimiento a nivel de las suturas craneales son numerosas, así como sobre las imposibilidades de que existe un MRP. La hipótesis más probable es que el motor del sistema cráneo sacro sea la respiración costal que a través de las tensiones fasciales y de la columna vertebral mueve el sistema craneal, vertebral y la pelvis. Las explicaciones del cómo funcionan las técnicas osteopáticas craneales a través de la neurofisiología ya existen, de la misma manera que se conocen las repercusiones neurológicas de las disfunciones suturales craneales. Este articulo propone además de una teoría nueva para explicar el mecanismo craneosacro, una lista de artículos científicos publicados sobre el tema (AU)

Cranial osteopathy should not be based on mysticism, they is not such a thing as famous primary respiratory movement (MRP), doesn't exist. The scientific studies demonstrating that a micro movement exists in the cranial sutures are numerous, as well as exist impossibilities for reality of the MRP. The hypothesis most acceptable is that the motor of the cranio-sacral system is the costal respiration that through the fasciales tensions and the spine moves the cranial, vertebral system and pelvis. The explanations of how are efficient cranial osteopathic techniques through the neuro-physiology already exist, in the same way that the neurological repercussions of the cranial sutures dysfunctions are known. This paper proposes besides a new theory to explain the cranio-sacral mechanism, a list of scientific articles published on the topic (AU)

Skull dysfunction.

Individuals commonly report a multitude of factors or triggers as the cause for the onset of a headache or facial pain. The challenge has always been to understand the many triggers, the diverse symptoms, the chronological characteristics, and the variability of location associated with headache and facial pain. Part I of this article presents theories and hypotheses proposing that the etiology of the final common pathway of headache and facial pain is from pain signals generated within the skull's joints. The model proposes to explain the variability in the triggers, symptoms, chronological aspects, and location known to be associated with headache and facial pain. The evidence to support these theories is clinical and anecdotal at this time. These theories need controlled investigation. A review of the anatomy of the skull's joints is provided. Part II of this article is a step-by-step description of the use of a nasal balloon device for the treatment of skull joint dysfunction. A review of the history and use of this and other methods of skull joint treatment is provided.

[Cranial osteopathy, delusion or reality?]. / L'ostéopathie crânienne, leurre ou realité?

After having outlined the theories of cranial osteopathy (SUTHERLAND, KARNI, UPLEDGER, and, more recently, CLAUZADE and DARRAILLANS), the authors refute the latter point by point. "Primary respiration" is in fact a way of thinking, and the various bones making up the calvaria and base of the skull, which are solidly synostosed in the adult, are clearly incapable of the pretended rhythmic displacements "described" by the osteopaths. Moreover, the C.R.L., like any liquid, is incompressible and mildly pulsatile. Conversely, although the brain clearly shows rhythmic pulsations, which every neuro-surgeon notes every day, the latter are exclusively connected to the vascular system.