Pinto Rayane de Oliveira, Peixoto Adriano Porto, Pinto Ary Dos Santos, Richieri-Costa Antonio, Zechi-Ceide Roseli Maria, Ozawa Terumi Okada, Dalben Gisele da Silva
Department of Orthodontics, Hospital of Rehabilitation of Craniofacial Anomalies.
Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo (USP), Bauru.
J Craniofac Surg. 2018 Sep;29(6):1596-1600. doi: 10.1097/SCS.0000000000004588.
The Richieri-Costa-Pereira syndrome (RCPS) is an autosomal-recessive acrofacial dysostosis caused by mutations in EIF4A3, characterized by mandibular cleft comprising other craniofacial anomalies and limb defects such as cleft palate/Robin Sequence, microstomia, absence of mandibular central incisors, minor ear anomalies, clubfeet and first and 5 ray defects. The findings from this study are useful for better understanding the morphological consequences of disorders of EIF4A3, and having a better picture of the anatomic characteristics of the syndrome for a better therapeutic planning. Twenty-four angular and linear variables were measured to assess anteroposterior and vertical (superior-inferior) position of the cranial base, maxilla, mandible, and facial profile. The cephalometric radiographic analysis was performed on 9 individuals with RCPS, obtained at a mean age of 10.3 years, and compared with randomly selected age-matched 9 controls, without clefts and with well-balanced faces, with mean age of 10.6 years (both groups range 8.1 to 13.7 years). t test was used for analysis of means and Levene test for equality of variances. The syndrome group presented severe mandibular hypoplasia and retrognathism (P = 0.009, P = 0.001), greater facial convexity (N'PnPog and N'SnPog, P < 0.05) in syndrome group compared with the control group (P = 0.003, P = 0.004). In conclusion, in the RCPS group, most craniofacial defects affect the lower facial third, considering the severely affected mandible.
里氏-科斯塔-佩雷拉综合征(RCPS)是一种由EIF4A3基因突变引起的常染色体隐性遗传性肢端颜面发育不全,其特征为下颌裂,并伴有其他颅面畸形和肢体缺陷,如腭裂/罗宾序列征、小口畸形、下颌中切牙缺失、耳部轻度畸形、马蹄内翻足以及第一和第五指(趾)骨缺陷。本研究结果有助于更好地理解EIF4A3紊乱的形态学后果,并更全面地了解该综合征的解剖学特征,从而制定更好的治疗方案。测量了24个角度和线性变量,以评估颅底、上颌骨、下颌骨和面部轮廓的前后位置和垂直(上下)位置。对9例平均年龄为10.3岁的RCPS患者进行了头影测量X线分析,并与随机选择的9例年龄匹配的对照者进行比较,这些对照者无腭裂且面部比例协调,平均年龄为10.6岁(两组年龄范围均为8.1至13.7岁)。采用t检验分析均值,采用Levene检验分析方差齐性。综合征组表现出严重的下颌发育不全和下颌后缩(P = 0.009,P = 0.001),与对照组相比,综合征组面部凸度更大(N'PnPog和N'SnPog,P < 0.05)(P = 0.003,P = 0.004)。总之,在RCPS组中,考虑到下颌骨受严重影响,大多数颅面缺陷影响面下1/3。