Advertisement

Child's Nervous System

, Volume 34, Issue 5, pp 947–955 | Cite as

3D morphological change of skull base and fronto-temporal soft-tissue in the patients with unicoronal craniosynostosis after fronto-orbital advancement

  • Bin Yang
  • Jian Ni
  • Binghang Li
Original Paper

Abstract

Purpose

This study aims to comprehensively evaluate the deformation of the skull base and fronto-temporal soft tissue in the patients with anterior plagiocephaly over 1 year of age by three-dimensional (3D) imaging after fronto-orbital advancement (FOA).

Methods

We quantitatively analyzed the surgical results and outcome of FOA performed in 10 patients with anterior plagiocephaly. The measurements of the skull base and fronto-temporal soft tissue were performed based on 3D computed tomography (CT) scan. We assessed symmetry of the skull base and fronto-temporal soft tissue change.

Results

The mean age of patients at FOA was 38.9 months. A significant asymmetry of the skull base was found in all the patients. The growth of the anterior and middle fossae was restricted and the deformation of the fronto-temporal region was marked by soft tissue measurements in different grades. On the follow-up CT images 23.6 months after surgery, there was prominent change (p < 0.05) between the two hemibases (CSO^ ratio) and between the lengths and angles of the anterior and middle cranial hemi-fossae (CX, CSX^, XSM^, XM ratio), especially in grade IIA. Anterior cranial vault asymmetry index obviously decreased to − 1.2 from 12% after surgery (p < 0.05). What’s more, ACA^ was also proved to be less after surgical correction (19.91° versus 8.29°, p < 0.01) in grade IIA. The change of fronto-temporal soft tissue was significant such as the frontal angle, the angle of the frontal plane, the fontal-temporal angle, and the angle of the temporal plane in different grades.

Conclusions

The asymmetry of the skull base and the deformation of the fronto-temporal region can be presented by intracranial view at over 1 year of age in different grades. FOA can correct the skeletal malformation of the fronto-temporal region as well as soft tissue and the asymmetry of the skull base was improved after surgical treatment.

Keywords

Anterior plagiocephaly Skull base Fronto-orbital advancement Craniometric analysis Soft tissue measurement 3D CT scan 

Notes

Funding information

This study is currently receiving the grant (Capital Clinical Medicine Special Project No. Z151100004015056) from Beijing Municipal Science and Technology Commission and the grant (CAMS Initiative for Innovative Medicine 2016-I2M-1-018) from Chinese Academy of Medical Sciences.

Compliance with ethical standards

Conflict of interest

There is no any conflict of interest.

References

  1. 1.
    Bertelsen TI (1957) The premature synostosis of the cranial sutures. Acta Ophthalmol Suppl 36(Suppl 51):1–176Google Scholar
  2. 2.
    Thompson DNP, Malcolm GP, Jones BM, Harkness WJ, Hayward RD (1995) Intracranial pressure in single-suture craniosynostosis. Pediatr Neurosurg 22(5):235–240.  https://doi.org/10.1159/000120907 CrossRefPubMedGoogle Scholar
  3. 3.
    Marsh JL, Vannier MW (1983) The “third” dimension in craniofacial surgery. Plast Reconstr Surg 71(6):759–767.  https://doi.org/10.1097/00006534-198306000-00002 CrossRefPubMedGoogle Scholar
  4. 4.
    Marsh JL, Gado MH, Vannier MW, Stevens WG (1986) Osseous anatomy of unilateral coronal synostosis. Cleft Palate J 23(2):87–100PubMedGoogle Scholar
  5. 5.
    Lo LJ, Marsh JL, Pilgram TK, Vannier MW (1996) Plagiocephaly: differential diagnosis based on endocranial morphology. Plast Reconstr Surg 97(2):282–291.  https://doi.org/10.1097/00006534-199602000-00003 CrossRefPubMedGoogle Scholar
  6. 6.
    McCarthy JG, Glasberg SB, Epstein FJ et al (1995) Twenty-year experience with early surgery for craniosynostosis: I. Isolated craniofacial synostosis—results and unsolved problems. Plast Reconstr Surg 96(2):272–283.  https://doi.org/10.1097/00006534-199508000-00004 CrossRefPubMedGoogle Scholar
  7. 7.
    Marchac D (1978) Radical forehead remodeling for craniostenosis. Plast Reconstr Surg 61(6):823–835.  https://doi.org/10.1097/00006534-197861060-00001 CrossRefPubMedGoogle Scholar
  8. 8.
    Haberl H, Tallen G, Michael T, Hoffmann KT, Benndorf G, Brock M (2004) Surgical aspects and outcome of delayed tethered cord release. Zentralbl Neurochir 65(04):161–167.  https://doi.org/10.1055/s-2004-832347 CrossRefPubMedGoogle Scholar
  9. 9.
    Tessier P (1971) The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis: Crouzon’s and Apert’s diseases. Plast Reconstr Surg 48(5):419–442.  https://doi.org/10.1097/00006534-197111000-00002 CrossRefPubMedGoogle Scholar
  10. 10.
    Marchac D, Renier D (1979) Le front flottant, traitement précoce des faciocraniosténoses. Ann Chir Plast 24(2):121–126PubMedGoogle Scholar
  11. 11.
    Mühling J (2000) Craniofacial abnormalities. Mund-, Kiefer-und Gesichtschirurgie: MKG 4(S1):S68–S75.  https://doi.org/10.1007/PL00022962 CrossRefPubMedGoogle Scholar
  12. 12.
    Smartt JM Jr, Elliott RM, Reid RR, Bartlett SP (2011) Analysis of differences in the cranial base and facial skeleton of patients with lambdoid synostosis and deformational plagiocephaly. Plast Reconstr Surg 127(1):303–312.  https://doi.org/10.1097/PRS.0b013e3181f95cd8 CrossRefPubMedGoogle Scholar
  13. 13.
    Ploplys EA, Hopper RA, Muzaffar AR, Starr JR, Avellino AM, Cunningham ML, Ellenbogen RG, Gruss JS (2009) Comparison of computed tomographic imaging measurements with clinical findings in children with unilateral lambdoid synostosis. Plast Reconstr Surg 123(1):300–309.  https://doi.org/10.1097/PRS.0b013e31819346b5 CrossRefPubMedGoogle Scholar
  14. 14.
    Captier G, Leboucq N, Bigorre M, Canovas F, Bonnel F, Bonnafé A, Montoya P (2003) Plagiocephaly: morphometry of skull base asymmetry. Surg Radiol Anat 25(3–4):226–233.  https://doi.org/10.1007/s00276-003-0118-x CrossRefPubMedGoogle Scholar
  15. 15.
    Di Rocco C, Paternoster G, Caldarelli M, Massimi L, Tamburrini G (2012) Anterior plagiocephaly: epidemiology, clinical findings, diagnosis, and classification. A review. Childs Nerv Syst 28(9):1413–1422.  https://doi.org/10.1007/s00381-012-1845-2 CrossRefPubMedGoogle Scholar
  16. 16.
    Hansen M, Padwa BL, Scott MR et al (1997) Synostotic frontal plagiocephaly: anthropometric comparison of three techniques for surgical correction. Plast Reconstr Surg 100(6):1387–1395.  https://doi.org/10.1097/00006534-199711000-00002 CrossRefPubMedGoogle Scholar
  17. 17.
    Marchac D, Cophignon J, Hirsch JF, Renier D (1978) Remodelage fronto-cranien des craniostenoses avec mobilisation du bandeau frontal. Neurochirurgie 24(1):23–31PubMedGoogle Scholar
  18. 18.
    Selber JC, Brooks C, Kurichi JE, Temmen T, Sonnad SS, Whitaker LA (2008) Long-term results following fronto-orbital reconstruction in nonsyndromic unicoronal synostosis. Plastic and Reconstructive Surgery 121(5):251e–260e.  https://doi.org/10.1097/PRS.0b013e31816a9f88 CrossRefPubMedGoogle Scholar
  19. 19.
    Engel M, Castrillon-Oberndorfer G, Hoffmann J, Mühling J, Seeberger R, Freudlsperger C (2013) Long-term results in nonsyndromatic unilateral coronal synostosis treated with fronto-orbital advancement. J Cranio-Maxillofac Surg 41(8):747–754.  https://doi.org/10.1016/j.jcms.2012.12.011 CrossRefGoogle Scholar
  20. 20.
    Mesa JM, Fang F, Muraszko KM, Buchman SR (2011) Reconstruction of unicoronal plagiocephaly with a hypercorrection surgical technique. Neurosurg Focus 31(2):E4.  https://doi.org/10.3171/2011.6.FOCUS1193 CrossRefPubMedGoogle Scholar
  21. 21.
    Manouvrier L (1883) Etude craniométrique sur la plagiocephalie. Bull Soc Anthrop Paris:526–553Google Scholar
  22. 22.
    Burdi A R. Early development of the human basicranium: its morphogenic controls, growth patterns and relations[C]//Symposium on Development of the Basicranium. Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health, 1976: 81–90Google Scholar
  23. 23.
    Di Rocco C, Velardi F (1988) Nosographic identification and classification of plagiocephaly. Childs Nerv Syst 4(1):9–15.  https://doi.org/10.1007/BF00274074 CrossRefPubMedGoogle Scholar
  24. 24.
    Knott VB (1971) Change in cranial base measures of human males and females from age 6 years to early adulthood. Growth 35(2):145–158PubMedGoogle Scholar
  25. 25.
    Yin H, Dong X, Yang B (2015) A new three-dimensional measurement in evaluating the cranial asymmetry caused by craniosynostosis. Surg Radiol Anat 37(8):989–995.  https://doi.org/10.1007/s00276-015-1430-y CrossRefPubMedGoogle Scholar
  26. 26.
    Martini M, Schulz M, Röhrig A, Nadal J, Messing-Jünger M (2015) A 3D morphometric follow-up analysis after frontoorbital advancement in non-syndromic craniosynostosis. J Cranio-Maxillofac Surg 43(8):1428–1437.  https://doi.org/10.1016/j.jcms.2015.07.018 CrossRefGoogle Scholar
  27. 27.
    Fearon JA, Ruotolo RA, Kolar JC (2009) Single sutural craniosynostoses: surgical outcomes and long-term growth. Plast Reconstr Surg 123(2):635–642.  https://doi.org/10.1097/PRS.0b013e318195661a CrossRefPubMedGoogle Scholar
  28. 28.
    Oh AK, Greene AK, Mulliken JB, Rogers GF (2006) Prevention of temporal depression that follows fronto-orbital advancement for craniosynostosis. J Craniofac Surg 17(5):980–985.  https://doi.org/10.1097/01.scs.0000230015.16401.1d CrossRefPubMedGoogle Scholar
  29. 29.
    van der Meulen JJNM, Willemsen J, van der Vlugt J et al (2009) On the origin of bitemporal hollowing. J Craniofac Surg 20(3):752–756.  https://doi.org/10.1097/SCS.0b013e3181a2e44a CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre of Maxillofacial Surgery and Digital Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical CollegeChinese Academy of Medical SciencesBeijingPeople’s Republic of China

Personalised recommendations