Lu Xiaona, Jorge Forte Antonio, Persing John A
Division of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, Conn.
Department of Genetics, Yale University School of Medicine, New Haven, Conn.
Plast Reconstr Surg Glob Open. 2021 Jul 20;9(7):e3616. doi: 10.1097/GOX.0000000000003616. eCollection 2021 Jul.
We propose a landmark-based, virtual coordinate system, specifically designed for assessment of asymmetrical craniofacial anatomy associated with unicoronal synostosis.
CT scans of 33 patients with nonsyndromic unicoronal synostosis were included. Proposed mid-sagittal plane was compared with commonly used sagittal planes: (1) nasion, sella, and basion (N-S-BA); (2) midplane of bilateral frontozygomatic sutures (midFZ); and (3) the skull gravity center plane, to evaluate reliability and validity in the assessments of the anterior and posterior skull base.
The proposed midplane is similar to the midFZ plane in describing the direction of the anterior skull base. However, it has less bias than the N-S-BA ( 0.001), and the gravity center planes ( 0.001). The proposed midplane measures the direction of the posterior skull base plane, similar to the midFZ and gravity center planes, but it has less measurement deviation than the N-S-BA plane ( 0.001). The most protrusive point on the frontal bone in unicoronal patients is contralateral to the fused suture and distant from the mid-sagittal plane by 13.93 ± 4.01 mm. In addition, it is more anteriorly positioned, by 5.32 mm ( 0.001), when compared with the corresponding point on the synostotic side. The uppermost point of the supraorbital rim on the synostotic side is cephalic to that of the contralateral side by 4.09 mm ( 0.001).
Prioritized orientation of an averaged Frankfort horizontal plane, followed by the location of the mid-sagittal and coronal planes, can generate a reliable and valid coordinate framework for the assessment of asymmetric skull shape in unicoronal synostosis.
我们提出了一种基于地标的虚拟坐标系，专门设计用于评估与单冠缝早闭相关的不对称颅面解剖结构。
纳入33例非综合征性单冠缝早闭患者的CT扫描图像。将提出的正中矢状面与常用的矢状面进行比较：（1）鼻根点、蝶鞍和颅底点（N-S-BA）；（2）双侧额颧缝的中间平面（midFZ）；以及（3）颅骨重心平面，以评估在前颅底和后颅底评估中的可靠性和有效性。
在描述前颅底方向时，提出的中间平面与midFZ平面相似。然而，它比N-S-BA平面（P<0.001）和重心平面（P<0.001）的偏差更小。提出的中间平面测量后颅底平面的方向，与midFZ平面和重心平面相似，但它比N-S-BA平面的测量偏差更小（P<0.001）。单冠缝患者额骨上最突出的点与融合缝对侧，距正中矢状面13.93±4.01mm。此外，与缝早闭侧的对应点相比，它更靠前，相差5.32mm（P<0.001）。缝早闭侧眶上缘的最上点比另一侧高4.09mm（P<0.001）。
优先确定平均法兰克福水平面的方向，然后确定正中矢状面和冠状面的位置，可以为评估单冠缝早闭中不对称颅骨形状生成一个可靠且有效的坐标框架。
