Calandrelli Rosalinda, D'Apolito Gabriella, Gaudino Simona, Stefanetti Mariangela, Massimi Luca, Di Rocco Concezio, Colosimo Cesare
Institute of Radiology, Università Cattolica Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy,
Neuroradiology. 2014 Oct;56(10):865-75. doi: 10.1007/s00234-014-1392-5. Epub 2014 Jul 10.
This study aims to identify the premature synostosis of "major" and "minor" sutures of the four "sutural arches" of the skull and to perform a morphometric analysis in children with syndromic craniosynostosis in order to evaluate changes in the skull base linked with premature suture synostosis.
We reviewed multiplanar high-resolution CT images, implemented with 3D reconstructions, from 18 patients with complex syndromic craniosynostosis and compared them with 18 age-matched healthy subjects. We assessed the calvarial sutures and their extension to the skull base, and then we correlated specific types of synostosis with the size, shape and symmetry of the cranial fossae.
We found a marked asymmetry of the skull base growth in all patients. The synostotic involvement around the coronal ring caused a reduction in the growth of the anterior and middle fossae. The size of the posterior cranial fossa was related not only to "major" but also to "minor" suture synostosis of the lambdoid and parieto-squamosal arches.
Changes in the skull base and craniofacial axis symmetry are due to structural and functional relationships between "major" and "minor" skull sutures, suggesting a structural and functional relationship between the neurocranium and basicranium. The early recognition of prematurely closed skull base sutures may help clinicians and neurosurgeons to establish correct therapeutic approaches.
本研究旨在确定颅骨四个“缝合弓”的“主要”和“次要”缝合线的过早融合，并对综合征性颅缝早闭患儿进行形态学分析，以评估与过早缝合线融合相关的颅底变化。
我们回顾了18例复杂综合征性颅缝早闭患者的多平面高分辨率CT图像，并进行了三维重建，将其与18名年龄匹配的健康受试者进行比较。我们评估了颅骨缝合线及其向颅底的延伸情况，然后将特定类型的融合与颅窝的大小、形状和对称性进行关联。
我们发现所有患者的颅底生长均存在明显不对称。冠状环周围的融合累及导致前颅窝和中颅窝生长减少。后颅窝的大小不仅与枕骨和顶颞缝的“主要”缝合线融合有关，还与“次要”缝合线融合有关。
颅底和颅面轴对称性的变化是由于“主要”和“次要”颅骨缝合线之间的结构和功能关系所致，提示脑颅和基颅之间存在结构和功能关系。早期识别过早闭合的颅底缝合线可能有助于临床医生和神经外科医生制定正确的治疗方案。
