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Plagiocephaly: morphometry of skull base asymmetry

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Abstract

The aim of this study was to perform a morphometric analysis of the skull base to understand the mechanism of asymmetry between malformational and deformational plagiocephaly. Since 1988, we have carried out 102 CT scans with three-dimensional reconstruction of the endocranial side of the skull base. There were 20 cases of malformational plagiocephaly, consisting of 18 unicoronal synostoses (UCS) and two unilambdoid synostoses (ULS), and 82 cases of plagiocephaly without synostosis, made up of 60 cases of frontal plagiocephaly (FP) and 22 of occipital plagiocephaly (OP). The skull base asymmetry was analyzed in three ways: (1) the hemibases and the cranial fossa angles were compared with each other; (2) the structural asymmetry of the chondrocranium was calculated; and (3) the architectural asymmetry was measured in relation to the medio-labyrinthine plane. The skull base asymmetry of malformational plagiocephaly was located in the anterior and middle cranial fossae for UCS and in the posterior and middle cranial fossae for ULS. The asymmetry was the result of a localized structural anomaly of the chondrocranium. The asymmetry of deformational plagiocephaly corresponded to a distortion in relation to the medio-labyrinthine plane while the chondrocranium remained symmetric. The skull base asymmetry of malformational plagiocephaly is secondary to a localized malformation of the chondrocranium, and that of the deformational plagiocephaly is secondary to an architectural deformation.

Résumé

Le but de cette étude était de réaliser une analyse morphométrique de la base du crâne pour comprendre les mécanismes de l'asymétrie entre les plagiocéphalies malformatives et déformatives. Depuis 1988, 102 reconstructions 3D de la surface endocrânienne de la base et al. âne ont été réalisées. Il s'agissait de 20 plagiocéphalies malformatives, 18 synostoses unicoronales (SUC) et 2 synostoses unilambdoïdes (SUL), et de 82 plagiocéphalies sans synostose, 60 plagiocéphalies frontales (PF) et 22 occipitales (PO). L'asymétrie de la base du crâne était analysée de trois manières: (1) les hémi-bases et les fosses crâniennes étaient comparées les unes aux autres, (2) l'asymétrie structurale du chondrocrâne était calculée, et (3) l'asymétrie architecturale était mesurée par rapport au plan médio-labyrinthique. L'asymétrie de la base du crâne des plagiocéphalies synostotiques était localisée aux fosses crâniennes antérieure et moyenne pour les SUC et aux fosses crâniennes postérieure et moyenne pour les SUL. L'asymétrie était secondaire à une anomalie de structure localisée du chondrocrâne. L'asymétrie des plagiocéphalies sans synostose correspondait à une distorsion autour du plan médio-labyrinthique alors que le chondrocrâne restait symétrique. L'asymétrie de la base du crâne des plagiocéphalies malformatives est secondaire à une malformation localisée du chondrocrâne, et celle des plagiocéphalies déformatives est secondaire à une déformation architecturale.

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Authors and Affiliations

  1. Unité de chirurgie plastique pédiatrique, hôpital Lapeyronie, 191 avenue du Doyen Gaston Giraud, 34295, Montpellier cedex 5, France

    G. Captier, M. Bigorre & P. Montoya

  2. Laboratoire d'anatomie, Université Montpellier I, 2 rue de l'école de médecine, 34000, Montpellier, France

    G. Captier, F. Canovas & F. Bonnel

  3. Service de neuroradiologie, hôpital Guy de Chauliac, 2 avenue Bertin Sans, 34295, Montpellier cedex 5, France

    N. Leboucq & A. Bonnafé

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  1. G. Captier
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  2. N. Leboucq
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  3. M. Bigorre
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  4. F. Canovas
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  5. F. Bonnel
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  6. A. Bonnafé
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  7. P. Montoya
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Correspondence to G. Captier.

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Captier, G., Leboucq, N., Bigorre, M. et al. Plagiocephaly: morphometry of skull base asymmetry. Surg Radiol Anat 25, 226–233 (2003). https://doi.org/10.1007/s00276-003-0118-x

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  • DOI: https://doi.org/10.1007/s00276-003-0118-x

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