Hoyte D A
Department of Human Morphology, University of Nottingham, Queen's Medical Centre, England.
Neurosurg Clin N Am. 1991 Jul;2(3):515-37.
In the normal growth of the cranial base, an outline of prenatal development stressed the common vertebrate plan, the patterning of mesenchymal tissues formed from and influenced by migrating neural crest cells. Details are given of the sequences of chondrification and ossification. Postnatal growth is approached in two ways--sagittal growth and transverse growth--involving detailed consideration of sutural growth and of resorptive expansion and remodeling in the whole base. New conclusions have been reached about the growth of the ethmoid, which continues for a longer time than was generally thought, and of its relation to orbital growth. The dependence of fossa growth upon the early, almost explosive growth of the brain is shown in the sequences of basicranial growth, with the maturation of the fossae in a rostrocaudal direction. Of all the suture systems affecting the base, the coronal ring is most important (with the spheno-occipital synchondrosis next in importance). An off-shoot of the coronal ring is noted, the pterygoid buttress, and its importance stressed in relation to maxillary and midface growth. These considerations of normal morphology are widened to explore the dysmorphologies of the nonsyndromic and syndromic craniosynostoses. The abnormal patterning of these synostoses is shown to lie partly in the common pathways of expressivity of the calvarial and basicranial suture systems, again particularly the coronal ring, and partly in the development and responsiveness of the bony units themselves, whether normal or hypoplastic, and of their soft-tissue matrices.
在颅底的正常生长过程中，产前发育的概述强调了常见的脊椎动物发育模式，即由迁移的神经嵴细胞形成并受其影响的间充质组织的模式化。文中给出了软骨化和骨化序列的详细信息。产后生长从矢状生长和横向生长两个方面进行探讨，这涉及对整个颅底缝生长以及吸收性扩张和重塑的详细考量。关于筛骨的生长得出了新的结论，其持续时间比通常认为的更长，以及它与眼眶生长的关系。颅底生长序列显示，颅窝生长依赖于大脑早期几乎呈爆发式的生长，颅窝沿头尾方向成熟。在影响颅底的所有缝系统中，冠状环最为重要（蝶枕软骨结合次之）。文中提到了冠状环的一个分支——翼突支柱，并强调了其在上颌骨和中面部生长中的重要性。对正常形态学的这些考量得到扩展，以探究非综合征性和综合征性颅缝早闭的畸形情况。这些颅缝早闭的异常模式化部分在于颅盖和颅底缝系统，尤其是冠状环的共同表达途径，部分在于骨单位本身（无论正常还是发育不全）及其软组织基质的发育和反应性。
