Richtsmeier J T, Grausz H M, Morris G R, Marsh J L, Vannier M W
Dept. of Cell Biology and Anatomy, Johns Hopkins University, School of Medicine, Baltimore, MD 21205.
Cleft Palate Craniofac J. 1991 Jan;28(1):55-67. doi: 10.1597/1545-1569_1991_028_0055_gotcbi_2.3.co_2.
The configuration of the neurocranium has long been used as a diagnostic tool in assessing infants with abnormal head shape. In the case of craniosynostosis, a characteristic shape is caused by a constraint placed on growth of the neurocranium by prematurely closed sutures and secondary accommodation to that constraint. This investigation is a preliminary test of our hypotheses of growth of the cranial base under these constraints. Three dimensional landmark coordinate data were collected from pre-, peri-, and postoperative CT scans of eleven patients from The Cleft Palate and Craniofacial Deformities Institute, St. Louis, MO. These data were used in two sets of analytical comparisons. Comparisons of preoperative and perioperative morphology were taken to represent preoperative growth, while comparisons of perioperative to postoperative CT scans represent postoperative growth. Finite-element scaling analysis (FESA) and Euclidean distance matrix analysis (EDMA) were used to make these comparisons. Our results show that in cases involving premature closure of the metopic, sagittal, and bilateral coronary sutures, predictions about growth of the cranial base made prior to analysis prove correct. In these forms of craniosynostosis there are characteristic and consistent changes in the cranial base in both pre- and postoperative growth. Preoperative and postoperative growth in patients diagnosed with unicoronal synostosis show a greater degree of individual variability and do not follow a predictable pattern.
长期以来，脑颅骨的形态一直被用作评估头部形状异常婴儿的诊断工具。在颅缝早闭的情况下，特征性形状是由过早闭合的缝线对脑颅骨生长的限制以及对该限制的二次适应所导致的。本研究是对我们关于在这些限制条件下颅底生长假说的初步测试。从密苏里州圣路易斯腭裂与颅面畸形研究所的11名患者的术前、围手术期和术后CT扫描中收集了三维地标坐标数据。这些数据用于两组分析比较。术前和围手术期形态的比较代表术前生长，而围手术期与术后CT扫描的比较代表术后生长。使用有限元缩放分析（FESA）和欧几里得距离矩阵分析（EDMA）进行这些比较。我们的结果表明，在涉及额缝、矢状缝和双侧冠状缝过早闭合的病例中，分析前对颅底生长的预测是正确的。在这些形式的颅缝早闭中，颅底在术前和术后生长中都有特征性且一致的变化。诊断为单冠状缝早闭的患者术前和术后生长表现出更大程度的个体差异，且不遵循可预测的模式。
