Rosalinda Calandrelli1, Fabio Pilato2, Luca Massimi2, Marco Panfili3, Gabriella D'Apolito3, Simona Gaudino3, Cesare Colosimo3. 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@policlinicogemelli.it. 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. 3. 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.
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.
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.
Authors: Humam Saltaji; Mostafa Altalibi; Michael P Major; Muhammed H Al-Nuaimi; Sawsan Tabbaa; Paul W Major; Carlos Flores-Mir Journal: J Oral Maxillofac Surg Date: 2013-10-09 Impact factor: 1.895
Authors: James Thomas Paliga; Jesse A Goldstein; Arastoo Vossough; Scott P Bartlett; Jesse Adam Taylor Journal: J Craniofac Surg Date: 2014-01 Impact factor: 1.046
Authors: Pradip R Shetye; Edward H Davidson; Michael Sorkin; Barry H Grayson; Joseph G McCarthy Journal: Plast Reconstr Surg Date: 2010-09 Impact factor: 4.730
Authors: Erik Nout; Natalja Bannink; Maarten J Koudstaal; Jifke F Veenland; Koen F M Joosten; Rene M L Poublon; Karel G H van der Wal; Irene M J Mathijssen; Eppo B Wolvius Journal: J Craniomaxillofac Surg Date: 2011-05-31 Impact factor: 2.078
Authors: Youssef Tahiri; J Thomas Paliga; Arastoo Vossough; Scott P Bartlett; Jesse A Taylor Journal: J Oral Maxillofac Surg Date: 2013-11-22 Impact factor: 1.895
Authors: N Bannink; E Nout; E B Wolvius; H L J Hoeve; K F M Joosten; I M J Mathijssen Journal: Int J Oral Maxillofac Surg Date: 2010-01-06 Impact factor: 2.789
Authors: Yanxian Lin; Xiaoyang Ma; Yuanliang Huang; Lin Mu; Liya Yang; Minghao Zhao; Fang Xie; Chao Zhang; Jiajie Xu; Jianjian Lu; Li Teng Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2021-01-15
Authors: Maxwell M Wang; Christos S Haveles; Brian K Zukotynski; Russell R Reid; Justine C Lee Journal: Ann Plast Surg Date: 2021-11-01 Impact factor: 1.539
Authors: Xiaona Lu; Rajendra Sawh-Martinez; Antonio Jorge Forte; Robin Wu; Raysa Cabrejo; Alexander Wilson; Derek M Steinbacher; Michael Alperovich; Nivaldo Alonso; John A Persing Journal: Plast Reconstr Surg Glob Open Date: 2019-03-20