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Quantitative evaluation of facial hypoplasia and airway obstruction in infants with syndromic craniosynostosis: relationship with skull base and splanchnocranium sutural pattern

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

Craniosynostostic syndromes are due to multisuture synostoses and affect the entire craniofacial skeleton. This study analyzed the facial complex and airways to quantify the relationship between insufficient facial growth, airways obstruction, and the sutural pattern of the splanchnocranium and cranial fossae.

Methods

Preoperative high-resolution CT images in 19 infants with syndromic craniosynostosis were quantitatively analyzed. Because all children showed involvement of minor sutures/synchondroses coursing in the posterior cranial fossa, they were divided into three groups according to the synostotic involvement of “minor” sutures/synchondroses coursing in anterior (ACF) and middle (MCF) cranial fossae: group 1 (ACF), group 2 (MCF), and group 3 (ACF-MCF). Analysis of the facial complex and airway was performed. Each group was compared with age-matched healthy subjects.

Results

Premature closure of skull base synchondroses of ACF and MCF was found only in groups MCF and ACF-MCF. Group MCF showed synostosis in the posterior branch of the coronal ring and reduced anterior hemifossae lengths while group ACF-MCF showed synostosis in the anterior branch of the coronal ring and reduced middle hemifossae lengths. No group showed reduced maxillary or mandibular volumes but group MCF showed synostosis of the zygomaticomaxillary sutures and maxillary retrusion. All groups showed reduced airway volume but group 2 had a higher degree of airway hypoplasia.

Conclusion

The skull base synostotic process drives the changes in facial complex growth and airway obstruction. Premature closure of synchondroses/sutures in the posterior branch of the coronal ring causes insufficient facial growth, maxillary retrusion, and more severe airway reduction.

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Authors and Affiliations

  1. Polo scienze delle immagini, di laboratorio ed infettivologiche, Area diagnostica per immagini, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1-00168, Rome, Italy

    Rosalinda Calandrelli, Marco Panfili, Gabriella D’Apolito, Simona Gaudino & Cesare Colosimo

  2. Polo scienze dell’invecchiamento, neurologiche, ortopediche e della testa-collo, Area neuroscienze, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy

    Fabio Pilato & Luca Massimi

Authors
  1. Rosalinda Calandrelli
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  2. Fabio Pilato
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  3. Luca Massimi
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  5. Gabriella D’Apolito
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  6. Simona Gaudino
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  7. Cesare Colosimo
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Correspondence to Rosalinda Calandrelli.

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Funding

No funding was received for this study.

Conflict of interest statement

CC consults for Bracco Diagnostics Inc. and Bayer HealthCare.

Ethical approval

We declare that all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Calandrelli, R., Pilato, F., Massimi, L. et al. Quantitative evaluation of facial hypoplasia and airway obstruction in infants with syndromic craniosynostosis: relationship with skull base and splanchnocranium sutural pattern. Neuroradiology 60, 517–528 (2018). https://doi.org/10.1007/s00234-018-2005-5

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