Craniofacial Dysmorphology in Infants With Non-Syndromic Unilateral Coronal Craniosynostosis.


Journal

The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410

Informations de publication

Date de publication:
01 Sep 2022
Historique:
received: 19 09 2021
accepted: 21 12 2021
pubmed: 12 1 2022
medline: 8 9 2022
entrez: 11 1 2022
Statut: ppublish

Résumé

Unilateral coronal craniosynostosis (UCS) is a congenital disorder resulting from the premature suture fusion, leading to complex primary and compensatory morphologic changes in the shape of not only the calvarium and but also into the skull base. This deformity typically requires surgery to correct the shape of the skull and prevent neurologic sequelae, including increased intracranial pressure, sensory deficits, and cognitive impairment. The present multicenter study sought to reverse-engineer the bone dysmorphogenesis seen in non-syndromic UCS using a geometric morphometric approach. Computed tomography scans for 26 non-syndromic UCS patients were converted to three-dimensional mesh models. Two hundred thirty-six unique anatomical landmarks and semi-landmarked curves were then plotted on each model, creating wireframe representations of the Patients' skulls. Generalized Procrustes superimposition, Principal Component Analysis, and heatmaps identified significant superior displacement of the ipsilateral orbit ("harlequin" eye deformity), anterior displacement of the ear ipsilateral to the fused coronal suture, acute deviation of midline skull base structures ipsilateral to the fused coronal suture and flattening of the parietal bone and associated failure to expand superiorly. The described technique illustrates the impact of premature coronal suture fusion on the development of the entire skull and proposes how bone dysmorphology contributes to the Patients' neurologic sequelae. By bridging novel basic science methodologies with clinical research, the present study quantitatively describes craniofacial development and bone dysmorphogenesis.

Sections du résumé

BACKGROUND BACKGROUND
Unilateral coronal craniosynostosis (UCS) is a congenital disorder resulting from the premature suture fusion, leading to complex primary and compensatory morphologic changes in the shape of not only the calvarium and but also into the skull base. This deformity typically requires surgery to correct the shape of the skull and prevent neurologic sequelae, including increased intracranial pressure, sensory deficits, and cognitive impairment.
METHODS METHODS
The present multicenter study sought to reverse-engineer the bone dysmorphogenesis seen in non-syndromic UCS using a geometric morphometric approach. Computed tomography scans for 26 non-syndromic UCS patients were converted to three-dimensional mesh models. Two hundred thirty-six unique anatomical landmarks and semi-landmarked curves were then plotted on each model, creating wireframe representations of the Patients' skulls.
RESULTS RESULTS
Generalized Procrustes superimposition, Principal Component Analysis, and heatmaps identified significant superior displacement of the ipsilateral orbit ("harlequin" eye deformity), anterior displacement of the ear ipsilateral to the fused coronal suture, acute deviation of midline skull base structures ipsilateral to the fused coronal suture and flattening of the parietal bone and associated failure to expand superiorly.
CONCLUSIONS CONCLUSIONS
The described technique illustrates the impact of premature coronal suture fusion on the development of the entire skull and proposes how bone dysmorphology contributes to the Patients' neurologic sequelae. By bridging novel basic science methodologies with clinical research, the present study quantitatively describes craniofacial development and bone dysmorphogenesis.

Identifiants

pubmed: 35013073
doi: 10.1097/SCS.0000000000008464
pii: 00001665-202209000-00060
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Pagination

1903-1908

Informations de copyright

Copyright © 2022 by Mutaz B. Habal, MD.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Références

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Auteurs

Christopher P Bellaire (CP)

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai.

Alex Devarajan (A)

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai.

James G Napoli (JG)

Division of Paleontology, American Museum of Natural History, New York, NY.

John W Rutland (JW)

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai.

Helen Liu (H)

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai.

Laya Jacob (L)

Division of Plastic and Reconstructive Surgery, Keck School of Medicine at the University of Southern California.
Children's Hospital Los Angeles, Los Angeles, CA.

Max Mandelbaum (M)

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai.

Farah Sayegh (F)

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai.

Ilana G Margulies (IG)

Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC.

Pedram Goel (P)

Department of Plastic Surgery, University of California, Irvine, CA; and.

Bradley N Delman (BN)

Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.

Mark M Urata (MM)

Division of Plastic and Reconstructive Surgery, Keck School of Medicine at the University of Southern California.
Children's Hospital Los Angeles, Los Angeles, CA.

Peter J Taub (PJ)

Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai.

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