DeLeon V B, Zumpano M P, Richtsmeier J T
Department of Cell Biology and Anatomy, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Cleft Palate Craniofac J. 2001 Mar;38(2):134-46. doi: 10.1597/1545-1569_2001_038_0134_teonso_2.0.co_2.
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.
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.
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.
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.
孤立性矢状缝早闭会导致舟状头型的脑颅骨，并伴有颅底形态异常，这为脑颅骨与颅底的发育关系提供了额外证据。矫正手术方法各异，但手术的直接影响仅限于脑颅骨。本研究探讨脑颅骨手术对颅底的继发影响。
对术前（n = 25）和术后（n = 12）的孤立性矢状缝早闭患者进行三维（3 - D）计算机断层扫描（CT）。从3 - D CT重建中收集颅底及其周围14个标志点的地标数据，并使用欧几里得距离矩阵分析进行分析。采用年龄匹配患者的子样本，以确定术前和术后患者的颅底差异，并将纵向数据中确定的术后生长模式与横断面数据中表征的术前生长模式进行比较。
术前和术后患者的颅底形态存在统计学显著差异（p≤0.10）。术前和术后患者鼻根点、右侧星点和左侧星点的相对位置相似。然而，这两组中这些标志点相对于颅底的位置不同，术后患者的位置相对更靠前。此外，我们发现术后第一年颅底角平均既没有增加也没有减少。这些形态学差异与手术侧和未手术侧颅底的不同生长轨迹相关。
无论具体手术方式如何，矢状缝早闭患者的脑颅骨手术都会影响颅底的生长模式。术后颅底角没有变化表明脑颅骨手术缓解了矢状缝早闭颅底中描述的枕骨旋转和颅底角减小。
