Purpose: Early onset of minor suture fusion in syndromic craniosynostosis is associated with midface dysplasia and is a common indication for craniofacial surgery. However, the potential effects of fusion severity on craniofacial growth patterns are not well understood. This study seeks to describe the impact of minor suture fusion severity on midface morphology in Crouzon syndrome. Methods: Pre-operative computed tomography images (CT) of 63 patients with Crouzon syndrome and 63 normocepahlic controls were included. Degree of suture fusion was assessed for the frontosphenoidal, sphenethmoidal, sphenosquamosal, sphenopetrosal, spheno-occipital synchondrosis, frontoethmoidal, and zygomaticosphenoidal sutures. Each suture was graded on a 5-point scale. The sella (S), nasion (N), A point (A), basion (BA), and anterior nasal spine (ANS) landmarks were used to calculate the SNA angle, BA-ANS length of the lower midface, and N-S length of the upper midface. Multiple linear regressions were used to analyze data. Results: The mean age was 43 months and 44% were female. The control group was significantly older (P < .01) than the patients with Crouzon syndrome. Advanced fusion of the spheno-occipital synchondrosis in Crouzon syndrome correlates with regression of the BA-ANS length by 0.563 mm per incremental increase in suture fusion (P < .01). Additionally, the lower midface (BA-ANS) was restricted to a greater degree than the upper midface (N-S) with progressive suture fusion in all patient types with ratios of these rates ranging between 0.602 and 0.89 for the 7 sutures analyzed. Suture fusion severity did not impact the SNA angle in any of the analyses performed. Conclusion: The severity of sheno-occipital synchondrosis fusion in Crouzon syndrome contributes to midface hypoplasia. Similarly, all anterior skull base sutures limited lower midface growth to a greater degree than the upper midface.
机构:
NYU, Med Ctr, Inst Reconstruct Plast Surg, Variety Ctr Craniofacial Rehabil, New York, NY 10016 USANYU, Med Ctr, Inst Reconstruct Plast Surg, Variety Ctr Craniofacial Rehabil, New York, NY 10016 USA
Katzen, JT
McCarthy, JG
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NYU, Med Ctr, Inst Reconstruct Plast Surg, Variety Ctr Craniofacial Rehabil, New York, NY 10016 USANYU, Med Ctr, Inst Reconstruct Plast Surg, Variety Ctr Craniofacial Rehabil, New York, NY 10016 USA
机构:
Seattle Childrens Hosp, Craniofacial Ctr, Div Plast & Craniofacial Surg, Seattle, WA 98105 USA
Univ Washington, Dept Surg, Div Plast Surg, Seattle, WA 98195 USASeattle Childrens Hosp, Craniofacial Ctr, Div Plast & Craniofacial Surg, Seattle, WA 98105 USA
Massenburg, Benjamin B.
Susarla, Srinivas M.
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Seattle Childrens Hosp, Craniofacial Ctr, Div Plast & Craniofacial Surg, Seattle, WA 98105 USA
Univ Washington, Dept Surg, Div Plast Surg, Seattle, WA 98195 USA
Univ Washington, Dept Oral & Maxillofacial Surg, Seattle, WA 98195 USASeattle Childrens Hosp, Craniofacial Ctr, Div Plast & Craniofacial Surg, Seattle, WA 98105 USA
Susarla, Srinivas M.
Kapadia, Hitesh P.
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Univ Washington, Dept Surg, Div Plast Surg, Seattle, WA 98195 USA
Seattle Childrens Hosp, Craniofacial Ctr, Div Craniofacial Orthodont, Seattle, WA 98105 USASeattle Childrens Hosp, Craniofacial Ctr, Div Plast & Craniofacial Surg, Seattle, WA 98105 USA
Kapadia, Hitesh P.
Hopper, Richard A.
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Seattle Childrens Hosp, Craniofacial Ctr, Div Plast & Craniofacial Surg, Seattle, WA 98105 USA
Univ Washington, Dept Surg, Div Plast Surg, Seattle, WA 98195 USASeattle Childrens Hosp, Craniofacial Ctr, Div Plast & Craniofacial Surg, Seattle, WA 98105 USA
机构:
Nagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, JapanNagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Mizutani, Kosuke
Kurimoto, Michihiro
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Aichi Childrens Hlth & Med Ctr, Dept Neurosurg, 7-426 Morioka Town, Obu, Aichi, JapanNagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Kurimoto, Michihiro
Nagakura, Masamune
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Aichi Childrens Hlth & Med Ctr, Dept Neurosurg, 7-426 Morioka Town, Obu, Aichi, JapanNagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Nagakura, Masamune
Nawashiro, Tomoki
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Aichi Childrens Hlth & Med Ctr, Dept Neurosurg, 7-426 Morioka Town, Obu, Aichi, JapanNagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Nawashiro, Tomoki
Nagai, Toshiya
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Aichi Dev Disabil Ctr Cent Hosp, Dept Neurosurg, Kasugai, Aichi, JapanNagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Nagai, Toshiya
Aoki, Kosuke
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Nagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Univ Miami, Miller Sch Med, Dept Neurol Surg, Miami, FL USANagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Aoki, Kosuke
Kato, Mihoko
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Aichi Childrens Hlth & Med Ctr, Dept Neurosurg, 7-426 Morioka Town, Obu, Aichi, JapanNagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
Kato, Mihoko
Saito, Ryuta
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Nagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, JapanNagoya Univ, Grad Sch Med, Dept Neurosurg, Nagoya, Japan
机构:
Weill Cornell Med Coll, Dept Otolaryngol Head & Neck Surg, Div Pediat Otolaryngol, New York, NY 10021 USAWeill Cornell Med Coll, Dept Otolaryngol Head & Neck Surg, Div Pediat Otolaryngol, New York, NY 10021 USA
Stater, Brian J.
Oomen, Karin P. Q.
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Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Div Pediat Otolaryngol, Dept Otolaryngol Head & Neck Surg, Utrecht, NetherlandsWeill Cornell Med Coll, Dept Otolaryngol Head & Neck Surg, Div Pediat Otolaryngol, New York, NY 10021 USA
Oomen, Karin P. Q.
Modi, Vikash K.
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Weill Cornell Med Coll, Dept Otolaryngol Head & Neck Surg, Div Pediat Otolaryngol, New York, NY 10021 USAWeill Cornell Med Coll, Dept Otolaryngol Head & Neck Surg, Div Pediat Otolaryngol, New York, NY 10021 USA