Orbital and Periorbital Dysmorphology in Untreated Pfeiffer Syndrome.


Journal

Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050

Informations de publication

Date de publication:
01 Apr 2022
Historique:
pubmed: 17 2 2022
medline: 9 4 2022
entrez: 16 2 2022
Statut: ppublish

Résumé

Visual impairment secondary to orbital and periorbital dysmorphology is frequent in Pfeiffer syndrome patients. The etiopathogenesis of this aberrancy, however, remains unclear. Untreated Pfeiffer syndrome patients (n = 31) and normal control subjects (n = 43) were compared. Craniometric and volumetric analyses related to the orbital and periorbital anatomy were performed using Materialise (Leuven, Belgium) software. Overall, orbital cavity volume of Pfeiffer patients is reduced by 28 percent (p < 0.001), compared to normal, starting before 3 months of age (p = 0.004). Globe volume was diminished by 10 percent (p = 0.041) before 3 months of age, yet tended to catch up thereafter. However, the retrobulbar soft-tissue volume remained smaller beyond 1 year of age (17 percent, p = 0.003). Globe volume projection beyond the bony orbit increased in all observed ages (82 percent, p < 0.001). The volumes of sphenoid bone, maxilla, and mandible proportionately were restricted by 24 to 25 percent (p = 0.003 to 0.035) before 3 months of age. The volume of maxilla and mandible gradually approximate normal; however, the sphenoid bone volume in Pfeiffer patients remains less than normal (p = 0.002) into childhood. The anteroposterior length of both the zygoma and the maxilla was reduced by 14 percent (p < 0.001). Anterior positioning of the zygoma is less by 23 percent (p < 0.001) in Pfeiffer patients overall, with anterior positioning of maxilla reduced similarly by 23 percent (p < 0.001). Pfeiffer syndrome patients develop decreased retrobulbar soft-tissue and globe volume, along with a restricted orbital cavity volume in infancy. Significant hypoplasia of the sphenoid bone is associated with more severe central facial (maxilla) retrusion, compared to lateral facial structures (zygoma). Risk, II.

Sections du résumé

BACKGROUND BACKGROUND
Visual impairment secondary to orbital and periorbital dysmorphology is frequent in Pfeiffer syndrome patients. The etiopathogenesis of this aberrancy, however, remains unclear.
METHODS METHODS
Untreated Pfeiffer syndrome patients (n = 31) and normal control subjects (n = 43) were compared. Craniometric and volumetric analyses related to the orbital and periorbital anatomy were performed using Materialise (Leuven, Belgium) software.
RESULTS RESULTS
Overall, orbital cavity volume of Pfeiffer patients is reduced by 28 percent (p < 0.001), compared to normal, starting before 3 months of age (p = 0.004). Globe volume was diminished by 10 percent (p = 0.041) before 3 months of age, yet tended to catch up thereafter. However, the retrobulbar soft-tissue volume remained smaller beyond 1 year of age (17 percent, p = 0.003). Globe volume projection beyond the bony orbit increased in all observed ages (82 percent, p < 0.001). The volumes of sphenoid bone, maxilla, and mandible proportionately were restricted by 24 to 25 percent (p = 0.003 to 0.035) before 3 months of age. The volume of maxilla and mandible gradually approximate normal; however, the sphenoid bone volume in Pfeiffer patients remains less than normal (p = 0.002) into childhood. The anteroposterior length of both the zygoma and the maxilla was reduced by 14 percent (p < 0.001). Anterior positioning of the zygoma is less by 23 percent (p < 0.001) in Pfeiffer patients overall, with anterior positioning of maxilla reduced similarly by 23 percent (p < 0.001).
CONCLUSIONS CONCLUSIONS
Pfeiffer syndrome patients develop decreased retrobulbar soft-tissue and globe volume, along with a restricted orbital cavity volume in infancy. Significant hypoplasia of the sphenoid bone is associated with more severe central facial (maxilla) retrusion, compared to lateral facial structures (zygoma).
CLINICAL QUESTION/LEVEL OF EVIDENCE METHODS
Risk, II.

Identifiants

pubmed: 35171849
doi: 10.1097/PRS.0000000000008928
pii: 00006534-202204000-00030
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

731e-742e

Informations de copyright

Copyright © 2022 by the American Society of Plastic Surgeons.

Références

Khong JJ, Anderson P, Gray TL, Hammerton M, Selva D, David D. Ophthalmic findings in Apert’s syndrome after craniofacial surgery: Twenty-nine years’ experience. Ophthalmology 2006;113:347–352.
Gray TL, Casey T, Selva D, Anderson PJ, David DJ. Ophthalmic sequelae of Crouzon syndrome. Ophthalmology 2005;112:1129–1134.
Sharma N, Greenwell T, Hammerton M, David DJ, Selva D, Anderson PJ. The ophthalmic sequelae of Pfeiffer syndrome and the long-term visual outcomes after craniofacial surgery. J AAPOS. 2016;20:315–319.
Ahmad F, Cobb ARM, Mills C, Jones BM, Hayward RD, Dunaway DJ. Frontofacial monobloc distraction in the very young: A review of 12 consecutive cases. Plast Reconstr Surg. 2012;129:488e–497e.
Raposo-Amaral CE, Denadai R, Zanco GL, Ghizoni E, Raposo-Amaral CA. Long-term follow-up on bone stability and complication rate after monobloc advancement in syndromic craniosynostosis. Plast Reconstr Surg. 2020;145:1025–1034.
Khonsari RH, Way B, Nysjö J, et al. Fronto-facial advancement and bipartition in Crouzon-Pfeiffer and Apert syndromes: Impact of fronto-facial surgery upon orbital and airway parameters in FGFR2 syndromes. J Craniomaxillofac Surg. 2016;44:1567–1575.
McCarthy JG, Glasberg SB, Cutting CB, et al. Twenty-year experience with early surgery for craniosynostosis: II. The craniofacial synostosis syndromes and pansynostosis—Results and unsolved problems. Plast Reconstr Surg. 1995;96:284–295.
Kreiborg S, Cohen MM Jr. Ocular manifestations of Apert and Crouzon syndromes: Qualitative and quantitative findings. J Craniofac Surg. 2010;21:1354–1357.
Lu X, Forte AJ, Sawh-Martinez R, et al. Anterior convex lateral orbital wall: Distinctive morphology in Apert syndrome. Br J Oral Maxillofac Surg. 2018;56:864–869.
Forte AJ, Steinbacher DM, Persing JA, Brooks ED, Andrew TW, Alonso N. Orbital dysmorphology in untreated children with Crouzon and Apert syndromes. Plast Reconstr Surg. 2015;136:1054–1062.
Lu X, Forte AJ, Steinbacher D, et al. Cephalocranial disproportionate fossa volume and normal skull base angle in Pfeiffer syndrome. J Craniofac Surg. 2021;32:581–586.
Lu X, Forte AJ, Steinbacher DM, et al. Nasopharyngeal airway and subcranial space analysis in Pfeiffer syndrome. Br J Oral Maxillofac Surg. 2021;59:592–598.
Lu X, Forte AJ, Park E, et al. Sphenoid bone structure and its influence on the cranium in syndromic versus nonsyndromic craniosynostosis. J Craniofac Surg. 2021;32:67–72.
Lu X, Forte AJ, Park KE, et al. Morphological basis for airway surgical intervention in Apert syndrome. Ann Plast Surg. 2021;87:59–64.
Lu X, Forte AJ, Park KE, et al. Airway development relevant to cranial vault suture synostosis subtype in Apert syndrome. FACE 2020;1:89–96.
Lu X, Forte AJ, Wilson A, et al. Cranial fossa volume and morphology development in Apert syndrome. Plast Reconstr Surg. 2020;145:790e–802e.
Lu X, Forte AJ, Sawh-Martinez R, et al. Temporal evaluation of craniofacial relationships in Apert syndrome. J Craniofac Surg. 2019;30:317–325.
Lu X, Forte AJ, Sawh-Martinez R, et al. Facial malformation in Crouzon’s syndrome is consistent with cranial base development in time and space. Plast Reconstr Surg Glob Open 2018;6:e1963.
Reitsma JH, Balk-Leurs IH, Ongkosuwito EM, Wattel E, Prahl-Andersen B. Dental maturation in children with the syndrome of Crouzon and Apert. Cleft Palate Craniofac J. 2014;51:639–644.
Way BLM, Khonsari RH, Karunakaran T, et al. Correcting exorbitism by monobloc frontofacial advancement in Crouzon-Pfeiffer syndrome: An age-specific, time-related, controlled study. Plast Reconstr Surg. 2019;143:121e–132e.
Chau A, Fung K, Pak K, Yap M. Is eye size related to orbit size in human subjects? Ophthalmic Physiol Opt. 2004;24:35–40.
Pearce E, Bridge H. Is orbital volume associated with eyeball and visual cortex volume in humans? Ann Hum Biol. 2013;40:531–540.
Masters M, Bruner E, Queer S, Traynor S, Senjem J. Analysis of the volumetric relationship among human ocular, orbital and fronto-occipital cortical morphology. J Anat. 2015;227:460–473.
Masters MP. Relative size of the eye and orbit: An evolutionary and craniofacial constraint model for examining the etiology and disparate incidence of juvenile-onset myopia in humans. Med Hypotheses 2012;78:649–656.
Martínez-Abadías N, Motch SM, Pankratz TL, et al. Tissue-specific responses to aberrant FGF signaling in complex head phenotypes. Dev Dyn. 2013;242:80–94.
Kreiborg S. Crouzon syndrome: A clinical and roentgencephalometric study. Scand J Plast Reconstr Surg Suppl. 1981;18:1–198.
Greenberg MF, Pollard ZF. Absence of multiple extraocular muscles in craniosynostosis. J AAPOS. 1998;2:307–309.
Ort V, Howard D. Development of the eye. Available at: http://education.med.nyu.edu/courses/macrostructure/lectures/lec_images/eye.html . Accessed June 9, 2015.
Hopper RA. New trends in cranio-orbital and midface distraction for craniofacial dysostosis. Curr Opin Otolaryngol Head Neck Surg. 2012;20:298–303.
Ter Maaten NS, Mazzaferro DM, Wes AM, Naran S, Bartlett SP, Taylor JA. Craniometric analysis of frontal cranial morphology following posterior vault distraction. J Craniofac Surg. 2018;29:1169–1173.
Kamer L, Noser H, Schramm A, Hammer B, Kirsch E. Anatomy-based surgical concepts for individualized orbital decompression surgery in graves orbitopathy. I. Orbital size and geometry. Ophthalmic Plast Reconstr Surg. 2010;26:348–352.
Lajeunie E, Heuertz S, El Ghouzzi V, et al. Mutation screening in patients with syndromic craniosynostoses indicates that a limited number of recurrent FGFR2 mutations accounts for severe forms of Pfeiffer syndrome. Eur J Hum Genet. 2006;14:289–298.
Wenger TL, Hopper RA, Rosen A, Tully HM, Cunningham ML, Lee A. A genotype-specific surgical approach for patients with Pfeiffer syndrome due to W290C pathogenic variant in FGFR2 is associated with improved developmental outcomes and reduced mortality. Genet Med. 2019;21:471–476.
O’Connor EJF, Marucci DD, Jeelani NO, et al. Ocular advancement in monobloc distraction. Plast Reconstr Surg. 2009;123:1570–1577.
Bender CA, Veneman W, Veenland JF, et al. Orbital aspects following monobloc advancement in syndromic craniosynostosis. J Craniomaxillofac Surg. 2013;41:e146–e153.
Nout E, van Bezooijen JS, Koudstaal MJ, et al. Orbital change following Le Fort III advancement in syndromic craniosynostosis: quantitative evaluation of orbital volume, infra-orbital rim and globe position. J Craniomaxillofac Surg. 2012;40:223–228.
Antunes RB, Camilo AA, da Silva AM, da Silva JV, Alonso N. Assessment of orbital volume in frontofacial advancements. J Craniofac Surg. 2015;26:843–848.
Way BLM, Khonsari RH, Karunakaran T, et al. Correcting exorbitism by monobloc frontofacial advancement in Crouzon-Pfeiffer syndrome: An age-specific, time-related, controlled study. Plast Reconstr Surg. 2019;143:121e–132e.
Motoki DS, Altobelli DE, Mulliken JB. Enophthalmos following orbital transposition for craniofacial malformations. Plast Reconstr Surg. 1993;91:416–422.
Greig AVH, Britto JA, Abela C, et al. Correcting the typical Apert face: Combining bipartition with monobloc distraction. Plast Reconstr Surg. 2013;131:219e–230e.
Khonsari RH, Way B, Nysjö J, et al. Fronto-facial advancement and bipartition in Crouzon-Pfeiffer and Apert syndromes: Impact of fronto-facial surgery upon orbital and airway parameters in FGFR2 syndromes. J Craniomaxillofac Surg. 2016;44:1567–1575.
Hopper RA, Kapadia H, Morton T. Normalizing facial ratios in apert syndrome patients with Le Fort II midface distraction and simultaneous zygomatic repositioning. Plast Reconstr Surg. 2013;132:129–140.
Oettlé AC, Demeter FP, L’abbé EN. Ancestral variations in the shape and size of the zygoma. Anat Rec (Hoboken) 2017;300:196–208.
Fearon JA, Rhodes J. Pfeiffer syndrome: A treatment evaluation. Plast Reconstr Surg. 2009;123:1560–1569.
Cohen MM Jr. Pfeiffer syndrome update, clinical subtypes, and guidelines for differential diagnosis. Am J Med Genet. 1993;45:300–307.

Auteurs

Xiaona Lu (X)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Antonio Jorge Forte (AJ)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Omar Allam (O)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Kitae Eric Park (KE)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Alexander Wilson (A)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Michael Alperovich (M)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Derek M Steinbacher (DM)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Cristiano Tonello (C)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Nivaldo Alonso (N)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

John A Persing (JA)

From the Division of Plastic and Reconstructive Surgery, Yale School of Medicine; Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida; Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo; and Department of Plastic Surgery, University of São Paulo.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH