Abstract
Purpose
The study aimed to identify premature synostosis of “major” and “minor” sutures of the coronal sutural arch and splanchnocranium sutures to evaluate the relationship between craniofacial dysmorphology and the sutural pattern in children with anterior plagiocephaly.
Methods
A quantitative analysis of the skull base and facial changes was performed on preoperative high-resolution CT images in 18 children with anterior synostotic plagiocephaly and compared with imaging findings in 18 age-matched healthy subjects.
Results
All patients had patent splanchnocranium sutures. Fifteen out of 18 children showed early and isolated synostosis of the unicoronal suture (the major suture of the coronal ring) and were classified in groups II and III according to the classification scheme of anterior synostotic plagiocephaly based on the severity of craniofacial dysmorphology. Premature fusion of the unilateral coronal suture in groups II and III caused a marked asymmetry and reduced growth of the anterior and middle fossae on the synostotic side and a secondary varying severity in terms of asymmetric growth of the facial complex. Although both groups showed anterior displacement of the mandibular articulation on the synostotic side, group II showed only maxillary asymmetry, while group III showed maxillary and mandibular asymmetry.
Conclusions
In anterior synostotic plagiocephaly, the severity of skull base changes and asymmetric growth of the facial complex is not caused by skull base sutural synostotic involvement but is probably related to the different timing of unilateral coronal suture closure.
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References
Beckett JS, Persing JA, Steinbacher DM Bilateral orbital dysmorphology in unicoronal synostosis. Plast Reconstr Surg 131:125–130
Calandrelli R, D'Apolito G, Gaudino S, Sciandra MC, Caldarelli M, Colosimo C Identification of skull base sutures and craniofacial anomalies in children with craniosynostosis: utility of multidetector CT. Radiol Med 119:694–704
Calandrelli R, D'Apolito G, Gaudino S, Stefanetti M, Massimi L, Di Rocco C, Colosimo C Radiological assessment of skull base changes in children with syndromic craniosynostosis: role of “minor” sutures. Neuroradiology 56:865–875
Captier G, Leboucq N, Bigorre M, Canovas F, Bonnel F, Bonnafe A, Montoya P (2003) Plagiocephaly: morphometry of skull base asymmetry. Surg Radiol Anat 25:226–233
Czorny A (2006) Movement of bone at the base and dysmorphogenesis of the skull. Neurochirurgie 52:160–183
de Ribaupierre S, Czorny A, Pittet B, Jacques B, Rilliet B (2007) Frontosphenoidal synostosis: a rare cause of unilateral anterior plagiocephaly. Childs Nerv Syst 23:1431–1438
Di Rocco C, Paternoster G, Caldarelli M, Massimi L, Tamburrini G Anterior plagiocephaly: epidemiology, clinical findings, diagnosis, and classification. A review. Childs Nerv Syst 28:1413–1422
Di Rocco C, Velardi F (1988) Nosographic identification and classification of plagiocephaly. Childs Nerv Syst 4:9–15
Dundulis JA, Becker DB, Govier DP, Marsh JL, Kane AA (2004) Coronal ring involvement in patients treated for unilateral coronal craniosynostosis. Plast Reconstr Surg 114:1695–1703
Gasparini G, Saponaro G, Marianetti TM, Tamburrini G, Moro A, Di Rocco C, Pelo S Mandibular alterations and facial lower third asymmetries in unicoronal synostosis. Childs Nerv Syst 29:665–671
Goodrich JT (2005) Skull base growth in craniosynostosis. Childs Nerv Syst 21:871–879
Heuze Y, Boyadjiev SA, Marsh JL, Kane AA, Cherkez E, Boggan JE, Richtsmeier JT New insights into the relationship between suture closure and craniofacial dysmorphology in sagittal nonsyndromic craniosynostosis. J Anat 217:85–96
Heuze Y, Martinez-Abadias N, Stella JM, Senders CW, Boyadjiev SA, Lo LJ, Richtsmeier JT Unilateral and bilateral expression of a quantitative trait: asymmetry and symmetry in coronal craniosynostosis. J Exp Zool B Mol Dev Evol 318:109–122
Kolar JC An epidemiological study of nonsyndromal craniosynostoses. J Craniofac Surg 22:47–49
Lajeunie E, Le Merrer M, Bonaiti-Pellie C, Marchac D, Renier D (1995) Genetic study of nonsyndromic coronal craniosynostosis. Am J Med Genet 55:500–504
Moss ML (1959) The pathogenesis of premature cranial synostosis in man. Acta Anat (Basel) 37:351–370
Moss ML, Salentijn L (1969) The primary role of functional matrices in facial growth. Am J Orthod 55:566–577
Moss ML (1979) Functional cranial analysis and the functional matrix. Int J Orthod 17:21–31
Pelo S, Tamburrini G, Marianetti TM, Saponaro G, Moro A, Gasparini G, Di Rocco C Correlations between the abnormal development of the skull base and facial skeleton growth in anterior synostotic plagiocephaly: the predictive value of a classification based on CT scan examination. Childs Nerv Syst 27:1431–1443
Pfaff MJ, Wong K, Persing JA, Steinbacher DM Zygomatic dysmorphology in unicoronal synostosis. J Plast Reconstr Aesthet Surg 66:1096–1102
Rogers GF, Mulliken JB (2005) Involvement of the basilar coronal ring in unilateral coronal synostosis. Plast Reconstr Surg 115:1887–1893
Selber J, Reid RR, Chike-Obi CJ, Sutton LN, Zackai EH, McDonald-McGinn D, Sonnad SS, Whitaker LA, Bartlett SP (2008) The changing epidemiologic spectrum of single-suture synostoses. Plast Reconstr Surg 122:527–533
Silveira Camargos I, Metzler P, Persing J, Alcon A, Steinbacher DM Nasal soft-tissue and vault deviation in unicoronal synostosis. J Plast Reconstr Aesthet Surg 68:615–621
Smartt JM Jr, Elliott RM, Reid RR, Bartlett SP Analysis of differences in the cranial base and facial skeleton of patients with lambdoid synostosis and deformational plagiocephaly. Plast Reconstr Surg 127:303–312
Tomlinson JK, Breidahl AF (2007) Anterior Fontanelle morphology in unilateral coronal synostosis: a clear clinical (nonradiographic) sign for the diagnosis of frontal plagiocephaly. Plast Reconstr Surg 119:1882–1888
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Calandrelli, R., D’Apolito, G., Massimi, L. et al. Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly. Childs Nerv Syst 32, 2339–2349 (2016). https://doi.org/10.1007/s00381-016-3218-8
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DOI: https://doi.org/10.1007/s00381-016-3218-8