Layton Ryan G, Pontier Joshua F, Bins Griffin P, Sucher Brandon J, Runyan Christopher M
Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Department of Plastic and Reconstructive Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA.
Cleft Palate Craniofac J. 2023 May;60(5):591-600. doi: 10.1177/10556656211072762. Epub 2022 Jan 19.
To identify skull-base growth patterns in Crouzon syndrome, we hypothesized premature minor suture fusion restricts occipital bone development, secondarily limiting foramen magnum expansion. Skull-base suture closure degree and cephalometric measurements were retrospectively studied using preoperative computed tomography (CT) scans and multiple linear regression analysis. Evaluation of multi-institutional CT images and 3D reconstructions from Wake Forest's Craniofacial Imaging Database (WFCID). Sixty preoperative patients with Crouzon syndrome under 12 years-old were selected from WFCID. The control group included 60 age- and sex-matched patients without craniosynostosis or prior craniofacial surgery. None. 2D and 3D cephalometric measurements. 3D volumetric evaluation of the basioccipital, exo-occipital, and supraoccipital bones revealed decreased growth in Crouzon syndrome, attributed solely to premature minor suture fusion. Spheno-occipital (β = -398.75; < .05) and petrous-occipital (β = -727.5; < .001) suture fusion reduced growth of the basioccipital bone; lambdoid suture (β = -14 723.1; < .001) and occipitomastoid synchondrosis (β = -16 419.3; < .001) fusion reduced growth of the supraoccipital bone; and petrous-occipital suture (β = -673.3; < .001), anterior intraoccipital synchondrosis (β = -368.47; < .05), and posterior intraoccipital synchondrosis (β = -6261.42; < .01) fusion reduced growth of the exo-occipital bone. Foramen magnum morphology is restricted in Crouzon syndrome but not directly caused by early suture fusion. Premature minor suture fusion restricts the volume of developing occipital bones providing a plausible mechanism for observed foramen magnum anomalies.
为了确定克鲁宗综合征患者颅底的生长模式，我们推测过早的小缝线融合会限制枕骨发育，进而限制枕大孔扩张。我们使用术前计算机断层扫描（CT）图像和多元线性回归分析，对颅底缝线闭合程度和头影测量进行了回顾性研究。评估了来自维克森林颅面成像数据库（WFCID）的多机构CT图像和三维重建图像。从WFCID中选取了60例12岁以下的克鲁宗综合征术前患者。对照组包括60例年龄和性别匹配、无颅缝早闭或既往颅面手术史的患者。无。二维和三维头影测量。对枕骨基底部、枕骨外侧部和枕骨上部进行三维容积评估，结果显示克鲁宗综合征患者这些部位的生长减少，这完全归因于过早的小缝线融合。蝶枕（β=-398.75；P<0.05）和岩枕（β=-727.5；P<0.001）缝线融合减少了枕骨基底部的生长；人字缝（β=-14723.1；P<0.001）和枕乳突软骨结合（β=-16419.3；P<0.001）融合减少了枕骨上部的生长；岩枕缝线（β=-673.3；P<0.001）、枕骨内前部软骨结合（β=-368.47；P<0.05）和枕骨内后部软骨结合（β=-6261.42；P<0.01）融合减少了枕骨外侧部的生长。克鲁宗综合征患者的枕大孔形态受到限制，但并非直接由早期缝线融合引起。过早的小缝线融合限制了发育中枕骨的体积，为观察到的枕大孔异常提供了一种合理的机制。
