| Title | The effect of neurocranial surgery on basicranial morphology in isolated sagittal craniosynostosis. | | Author(s) | DeLeon VB, Zumpano MP, Richtsmeier JT | | Institution | Department of Cell Biology and Anatomy, Johns Hopkins University School of Medicine, Baltimore, MD, USA. | | Source | Cleft Palate Craniofac J 2001 Mar; 38(2):134-46. | | MeSH | Case-Control Studies
Cephalometry
Child, Preschool
Comparative Study
Confidence Intervals
Craniosynostoses
Cross-Sectional Studies
Female
Follow-Up Studies
Frontal Bone
Humans
Image Processing, Computer-Assisted
Infant
Male
Nasal Bone
Occipital Bone
Parietal Bone
Petrous Bone
Research Support, U.S. Gov't, P.H.S.
Skull Base
Sphenoid Bone
Statistics
Temporal Bone
Tomography, X-Ray Computed
| | Abstract | OBJECTIVE: Isolated sagittal craniosynostosis produces a scaphocephalic neurocranium associated with abnormal basicranial morphology, providing additional evidence of the developmental relationship of the neurocranium and basicranium. Corrective surgical procedures vary, but the immediate impact of the surgical procedure is restricted to the neurocranium. This study addresses the secondary effects of neurocranial surgery on the cranial base.
DESIGN: Three-dimensional (3-D) computed tomography (CT) scans were obtained for preoperative (n = 25) and postoperative (n = 12) patients with isolated sagittal synostosis. Landmark data from 14 landmarks on and around the cranial base were collected from 3-D CT reconstructions and analyzed using Euclidean distance matrix analysis. Subsamples of age-matched patients were used to identify basicranial differences in pre- and postoperative patients and to compare postoperative growth patterns identified in longitudinal data with preoperative growth patterns characterized in cross-sectional data.
RESULTS: Statistically significant differences (p < or = 0.10) were found in the morphology of the cranial base in preoperative and postoperative patients. The relative positions of the landmarks nasion, right asterion, and left asterion are similar in preoperative and postoperative patients. However, the position of these landmarks relative to the cranial base is different in the two groups, being positioned relatively more anteriorly in postoperative patients. In addition, we found that the cranial base angle, on average, neither increases nor decreases in the first postoperative year. These morphological differences are associated with divergent growth trajectories in the operated and unoperated cranial base.
CONCLUSION: Regardless of specific procedure, neurocranial surgery in sagittal synostosis patients affects growth patterns of the cranial base. The lack of change in the postoperative cranial base angle suggests that neurocranial surgery alleviates the occipital rotation and decreased cranial base angle described in the sagittal synostosis basicranium. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 11294541 |
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