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Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly

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Abstract

Purpose

The study aimed to identify premature synostosis of “major” and “minor” sutures of the coronal sutural arch and splanchnocranium sutures to evaluate the relationship between craniofacial dysmorphology and the sutural pattern in children with anterior plagiocephaly.

Methods

A quantitative analysis of the skull base and facial changes was performed on preoperative high-resolution CT images in 18 children with anterior synostotic plagiocephaly and compared with imaging findings in 18 age-matched healthy subjects.

Results

All patients had patent splanchnocranium sutures. Fifteen out of 18 children showed early and isolated synostosis of the unicoronal suture (the major suture of the coronal ring) and were classified in groups II and III according to the classification scheme of anterior synostotic plagiocephaly based on the severity of craniofacial dysmorphology. Premature fusion of the unilateral coronal suture in groups II and III caused a marked asymmetry and reduced growth of the anterior and middle fossae on the synostotic side and a secondary varying severity in terms of asymmetric growth of the facial complex. Although both groups showed anterior displacement of the mandibular articulation on the synostotic side, group II showed only maxillary asymmetry, while group III showed maxillary and mandibular asymmetry.

Conclusions

In anterior synostotic plagiocephaly, the severity of skull base changes and asymmetric growth of the facial complex is not caused by skull base sutural synostotic involvement but is probably related to the different timing of unilateral coronal suture closure.

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Authors and Affiliations

  1. Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy

    Rosalinda Calandrelli, Gabriella D’Apolito, Simona Gaudino, Emiliano Visconti & Cesare Colosimo

  2. Istituto di Neurochirurgia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy

    Luca Massimi & Concezio Di Rocco

  3. Istituto di Chirurgia Maxillo-Facciale, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy

    Sandro Pelo

Authors
  1. Rosalinda Calandrelli
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  2. Gabriella D’Apolito
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  3. Luca Massimi
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  4. Simona Gaudino
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  5. Emiliano Visconti
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  6. Sandro Pelo
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  7. Concezio Di Rocco
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  8. Cesare Colosimo
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Corresponding author

Correspondence to Rosalinda Calandrelli.

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Calandrelli, R., D’Apolito, G., Massimi, L. et al. Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly. Childs Nerv Syst 32, 2339–2349 (2016). https://doi.org/10.1007/s00381-016-3218-8

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  • DOI: https://doi.org/10.1007/s00381-016-3218-8

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