Calandrelli Rosalinda, Pilato Fabio, Massimi Luca, Panfili Marco, Di Rocco Concezio, Colosimo Cesare
Polo scienze delle immagini, di laboratorio ed infettivologiche Area diagnostica per immagini Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
Polo scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Area neuroscienze Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
Childs Nerv Syst. 2018 Sep;34(9):1725-1733. doi: 10.1007/s00381-018-3824-8. Epub 2018 May 14.
The effects of premature fusion of one coronal suture cause skull and orbital alterations in term of side-to-side asymmetry. This study aimed to quantify the cranio-orbital complex changes related to the severity of skull base dysmorphology in patients with unicoronal synostosis.
Twenty-four infants affected by unicoronal synostosis were subdivided in three subgroups according to the severity of skull base deformity and their high-resolution CT images were quantitatively analyzed (groups IIa, IIb, III). Dimensions of cranial fossae, intracranial volume (ICV), ICV synostotic and ICV non synostotic side, whole brain volume (WBV), orbital volumes (OV), ICV/WBV, ICV/ICV, and OV/OV were evaluated.
Asymmetry and reduction in the growth of the anterior and middle fossae were found in all groups while asymmetry of the posterior cranial fossa was found only in IIb and III groups. In all groups, ICV, WBV, and ICV/WBV were not significantly different while ICVICV and OVOV resulted significant difference (p < 0.05). ICV resulted reduction only in group III. OV on the synostotic side was not significantly reduced although a trend in progressively reducing volumes was noted according to the severity of the group.
Skull and orbital changes revealed a side-to-side asymmetry but the effects of the premature synostosis were more severe in group III suggesting an earlier timing of premature unicoronal synostosis in group III with respect to the other groups. The assessment of the skull base deformity might be an indirect parameter of severity of skull orbital changes and it might be useful for surgical planning.
一条冠状缝过早融合会导致颅骨和眼眶出现左右不对称的改变。本研究旨在量化单冠状缝早闭患者颅眶复合体变化与颅底畸形严重程度之间的关系。
根据颅底畸形的严重程度，将24名单冠状缝早闭的婴儿分为三个亚组，并对其高分辨率CT图像进行定量分析（IIa组、IIb组、III组）。评估颅窝尺寸、颅内体积（ICV）、ICV早闭侧和ICV非早闭侧、全脑体积（WBV）、眼眶体积（OV）、ICV/WBV、ICV/ICV以及OV/OV。
所有组均发现前颅窝和中颅窝生长不对称且减小，而后颅窝不对称仅在IIb组和III组中发现。所有组中，ICV、WBV和ICV/WBV无显著差异，而ICV/ICV和OV/OV有显著差异（p < 0.05）。ICV仅在III组中减小。早闭侧的OV虽未显著减小，但根据分组严重程度可观察到体积逐渐减小的趋势。
颅骨和眼眶变化显示出左右不对称，但III组中早闭的影响更为严重，这表明III组单冠状缝早闭的发生时间比其他组更早。颅底畸形的评估可能是颅眶变化严重程度的一个间接参数，对手术规划可能有用。
