Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Frontal bossing, also known as skull bossing, is a skeletal deformity that causes the frontal bones of the skull to become enlarged and protrude, resulting in an unusually pronounced forehead. There may also be heavier-than-normal brow ridge.
While a prominent forehead and brow may be normal inherited features (an example being Australian aboriginal people who tend to have heavy brow ridges), frontal bossing may also be a sign of a medical condition.These include rare genetic and hormonal disorders that can affect bone development in children during and after pregnancy.
This article describes the symptoms and causes of frontal bossing, including how the condition and underlying cause are diagnosed and treated.
Verywell / Joules Garcia
Frontal Bossing Symptoms
Frontal bossing can differ based on the underlying cause. In some cases, the enlargement may not be recognized in a newborn and only becomes apparent as the child ages and moves into adolescence.
Symptoms of frontal bossing include:
The term “frontal bossing” is sometimes used ingender-affirming surgeryto describe a heavier brow ridge in males. As part of gender-affirming surgery, the brow ridge may be surgically reduced and contoured as part of the “feminization” oftransgender women.
Possible Causes of Frontal Bossing
Frontal bossing may be a sign of an underlying genetic syndrome, hormonal disorder, or congenital infection (meaning one that was passed from the mother to the child during pregnancy).
Some possible causes of frontal bossing include:
Diagnosing Frontal Bossing
Among the questions that may be asked:
From there, the healthcare provider will likely order lab tests based on the suspected cause. These might include:
Various head imaging modalities may also be used, including:
It is also possible to detect frontal bossing during pregnancy during aprenatal ultrasound.This may be ordered if maternal syphilis or rickets is diagnosed or the parents have a known genetic disorder. Even so, an ultrasound may only have limited value as frontal bossing is often not seen until a child is older.
How Frontal Bossing Is Treated
There is no treatment to reverse frontal bossing itself. Treatment of the underlying condition will likely not reverse your child’s condition, but it may keep it from getting worse.
Frontal bossing is not reversible and a child can’t really “grow out of it.” However, as a person reaches adulthood, the prominence may not be as noticeable (particularly in males who tend to have heavier brow ridges). Different hairstyles can also help minimize the appearance of an enlarged forehead.
If frontal bossing is severe or causing distress, cosmetic surgery may be explored. This is especially true if the bone malformation interferes with the field of vision.
Generally speaking, corrective surgery is not considered until skull bone growth is complete, usually around the end of puberty. Even then, there is no standard approach to surgery.
Depending on the severity of frontal bossing, the surgery may involve burring (abrading away excess bone), burring with hydroxyapatite (a mineral compound used to contour the brow), orosteotomy(the cutting, reshaping, and repositioning of bones).
Summary
While frontal bossing cannot be treated, the underlying condition can be treated or managed to avoid progression. In severe cases, corrective cosmetic surgery may be explored.
14 Sources
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