Understanding the heterogenicity of unicoronal synostosis - A morphometric analysis of cases compared to controls.

Craniosynostosis Dice similarity coefficient Severity Symmetry Unicoronal craniosynostosis

Journal

Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239

Informations de publication

Date de publication:
18 Sep 2024
Historique:
received: 27 02 2024
revised: 01 09 2024
accepted: 11 09 2024
medline: 3 10 2024
pubmed: 3 10 2024
entrez: 2 10 2024
Statut: aheadofprint

Résumé

Preoperative severity of unicoronal synostosis varies greatly and involves the frontal bone, skull base and orbits. Degree of deformity affects long-term morphological and functional outcomes after surgery. The aim of this study was to describe the morphological heterogenicity and investigate its relation to patient-specific factors. In this retrospective cohort study, non-syndromic unicoronal synostosis patients treated between 2006 and 2022 at Necker Hospital, France or Uppsala University Hospital, Sweden, were included and matched to controls. Severity of skull base, orbital and posterior skull asymmetry, degree of anterior plagiocephaly and Harlequin deformity, lateralisation, head circumference, age, timing of metopic fusion and fusion of peri-pterionic sutures were investigated. Ninety-five patients and ninety-three controls were included. Skull base asymmetry was linearly related to orbital asymmetry (p < 0.001), correlated with earlier CT scans (p = 0.004) and anterior (p < 0.001) and posterior (p = 0.03) plagiocephaly. Posterior plagiocephaly was more common in patients (31%) compared with controls (5%) (p < 0.001). A patent metopic suture above nine months of age was associated with severe Harlequin deformity (p = 0.04) and a lower head circumference when fused (p = 0.03). Fronto-sphenoidal suture fusion was associated with later CT scans (p < 0.001) and less skull base asymmetry (p = 0.002). Spheno-parietal fusion was correlated with decreased skull base asymmetry (p = 0.03). Right lateralisation was more common in females. Heterogenicity of unicoronal synostosis seems to be predominantly explained by variability in skull base morphology. Peri-pterionic fusions might limit deformity.

Sections du résumé

BACKGROUND BACKGROUND
Preoperative severity of unicoronal synostosis varies greatly and involves the frontal bone, skull base and orbits. Degree of deformity affects long-term morphological and functional outcomes after surgery. The aim of this study was to describe the morphological heterogenicity and investigate its relation to patient-specific factors.
MATERIALS AND METHODS METHODS
In this retrospective cohort study, non-syndromic unicoronal synostosis patients treated between 2006 and 2022 at Necker Hospital, France or Uppsala University Hospital, Sweden, were included and matched to controls. Severity of skull base, orbital and posterior skull asymmetry, degree of anterior plagiocephaly and Harlequin deformity, lateralisation, head circumference, age, timing of metopic fusion and fusion of peri-pterionic sutures were investigated.
RESULTS RESULTS
Ninety-five patients and ninety-three controls were included. Skull base asymmetry was linearly related to orbital asymmetry (p < 0.001), correlated with earlier CT scans (p = 0.004) and anterior (p < 0.001) and posterior (p = 0.03) plagiocephaly. Posterior plagiocephaly was more common in patients (31%) compared with controls (5%) (p < 0.001). A patent metopic suture above nine months of age was associated with severe Harlequin deformity (p = 0.04) and a lower head circumference when fused (p = 0.03). Fronto-sphenoidal suture fusion was associated with later CT scans (p < 0.001) and less skull base asymmetry (p = 0.002). Spheno-parietal fusion was correlated with decreased skull base asymmetry (p = 0.03). Right lateralisation was more common in females.
CONCLUSIONS CONCLUSIONS
Heterogenicity of unicoronal synostosis seems to be predominantly explained by variability in skull base morphology. Peri-pterionic fusions might limit deformity.

Identifiants

DOI: 10.1016/j.bjps.2024.09.044 PMID: 39357137
pubmed: 39357137
pii: S1748-6815(24)00597-7
doi: 10.1016/j.bjps.2024.09.044
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

76-84

Informations de copyright

Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Auteurs

H Lif (H)

Department of Surgical Sciences, Plastic surgery, Uppsala University, Uppsala, Sweden. Electronic address: hanna.lif@uu.se.

J Nysjö (J)

Department of Information Technology, Visual information and interaction, Uppsala University, Uppsala, Sweden.

M Geoffroy (M)

Craniofacial Growth and Form laboratory, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France; Arts et Métiers Institute of Technology, Université Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013 Paris, France.

G Paternoster (G)

Department of Neurosurgery, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.

M Taverne (M)

Craniofacial Growth and Form laboratory, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.

R Khonsari (R)

Craniofacial Growth and Form laboratory, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France; Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TeteCou, France; Department of Maxillofacial surgery and Plastic surgery, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France; Faculté de Médecine, Université Paris Cité, Paris, France.

D Nowinski (D)

Department of Surgical Sciences, Plastic surgery, Uppsala University, Uppsala, Sweden.

Classifications MeSH