Nevaste-Boldt Tuuli, Saarikko Anne, Kaprio Laura, Leikola Junnu, Kiukkonen Anu
Department of Cleft Palate and Craniofacial Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Orthodontics, Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Orthod Craniofac Res. 2023 May;26(2):216-223. doi: 10.1111/ocr.12603. Epub 2022 Sep 10.
In unilateral lambdoid craniosynostosis (ULC), the posteriorly situated lambdoid suture of the cranial vault fuses prematurely. Positional posterior plagiocephaly (PPP) causes flattening of the posterior side of the head, either through external forces or through underlying differences in brain development. Both conditions cause occipital flattening of the head, but the aetiology is different.
Eight ULC children were compared with 16 sex- and age-matched PPP children. 3D computer tomography scans of all 24 children were analysed with Dolphin imaging software. The location and symmetry of the temporomandibular joint (Co), and the symmetry of the maxillary anterior nasal spine (ANS) and the mandibular symphysis (Pgn) were analysed. Furthermore, the mandibular bone (Co-Pgn) length, corpus length, ramus height, positional changes in the external acoustic meatus (PoL) and the distance from the orbital margin to the articular fossa were measured.
In all eight ULC children, the Co was anteriorly displaced on the affected side compared with the unaffected side. In all ULC and PPP children, the ANS, which is considered the bony maxillary midpoint, was shifted towards the affected side. In all ULC children, the mandibular bone (Co-Pgn) was shorter on the affected side. The PoL was antero-inferiorly positioned in all ULC children on the affected side compared with the unaffected side.
Our results show that both types of posterior plagiocephaly are associated with an asymmetric position of the Co and asymmetry of the mandible and maxilla. Facial asymmetry was more frequently seen in ULC than PPP children.
在单侧人字缝早闭（ULC）中，颅顶后部的人字缝过早融合。姿势性后斜头畸形（PPP）可通过外力或潜在的脑发育差异导致头部后侧扁平。这两种情况都会导致头部枕部扁平，但病因不同。
将8例ULC患儿与16例性别和年龄匹配的PPP患儿进行比较。使用Dolphin成像软件分析所有24例患儿的三维计算机断层扫描。分析颞下颌关节（Co）的位置和对称性，以及上颌前鼻棘（ANS）和下颌联合（Pgn）的对称性。此外，测量下颌骨（Co-Pgn）长度、体部长度、升支高度、外耳道（PoL）的位置变化以及眶缘至关节窝的距离。
在所有8例ULC患儿中，患侧的Co相对于未患侧向前移位。在所有ULC和PPP患儿中，被认为是上颌骨骨性中点的ANS向患侧移位。在所有ULC患儿中，患侧的下颌骨（Co-Pgn）较短。与未患侧相比，所有ULC患儿患侧的PoL位于前下方。
我们的结果表明，两种类型的后斜头畸形均与Co的不对称位置以及下颌骨和上颌骨的不对称有关。与PPP患儿相比，ULC患儿中面部不对称更为常见。
