A Case of Squamosal Craniosynostosis from the 16 th Century Southeastern United States W. N. DUNCAN a * AND C. M. STOJANOWSKI b a Department of Anthropology, St. John Fisher College, Rochester, NY 14618, USA b School of Human Evolution and Social Change, Center for Bioarchaeological Research, Arizona State University, Tempe, AZ 85287, USA ABSTRACT This paper describes a case of plagiocephaly stemming from a unilateral synostosis of the left squamosal and coronal sutures in a 16 th century calvaria from Georgia. Although cases of squamosal involvement in syndromic, multisuture synostotic cases have been found in the archaeological record, isolated squamosal involvement is quite rare. Our literature review found only 15 such cases reported, and this is the first case to be reported from the southeastern United States. Despite the fact that the bevelled nature of the squamosal suture is unique in the human body and that the cause for squamosal involvement remains unclear, to our knowledge there have been no reviews of the nosology and aetiology of synostosis with particular reference to the squamosal suture in the anthropological or clinical literature. Isolated squamosal craniosynostosis may be frequently unreported in clinical settings, and thus case studies on the condition in archaeological contexts may prove valuable for future attempts to identify the frequency and causes of squamosal involvement. This case study also highlights both the potential and challenges of using rare pathological conditions as a tool for positive identification of human remains in historical forensic cases. Copyright ß 2007 John Wiley & Sons, Ltd. Key words: craniosynostosis; squamosal suture; coronal suture; plagiocephaly; southeastern United States Introduction Craniosynostosis is a condition defined by the pre- mature closure of cranial sutures. The condition is sometimes referred to as craniostenosis (Ortner, 2003), although there exists some discussion regarding the relationship between the two terms. Kennedy et al. (1993; following Shulman, 1973) noted that craniosynostosis is the general term for premature synostosis, while cranioste- nosis is defined as involving abnormal shape but not size. However, Cohen (1993: 594; also see Bixler & Ward, 1987: 115) noted that: ‘craniosynostosis is the process of premature sutural fusion, craniostenosis, the result. Actu- ally the terms have been used interchangeably, and craniosynostosis seems to be replacing craniostenosis as the more common term.’ We follow Cohen (1993) in this paper. Here we report a rare case of plagiocephaly with corresponding unilateral squamosal craniosynos- International Journal of Osteoarchaeology Int. J. Osteoarchaeol. 18: 407–420 (2008) Published online 2 November 2007 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/oa.943 * Correspondence to: Department of Anthropology, St. John Fisher College, Rochester, NY 14618, USA. e-mail: bduncan@sjfc.edu Copyright # 2007 John Wiley & Sons, Ltd. Received 22 May 2006 Revised 22 May 2007 Accepted 28 May 2007