The effect of neurocranial surgery on basicranial morphology in isolated sagittal craniosynostosis

Valerie Burke DeLeon, Michael P. Zumpano, Joan T. Richtsmeier

Research output: Contribution to journalArticle

Abstract

Objective: Isolated sagittal craniosynostosis produces a scaphocephalic neurocranium associated with abnormal basicranial morphology, providing additional evidence of the developmental relationship of the neurocranium and basicranium. Corrective surgical procedures vary, but the immediate impact of the surgical procedure is restricted to the neurocranium. This study addresses the secondary effects of neurocranial surgery on the cranial base. Design: Three-dimensional (3-D) computed tomography (CT) scans were obtained for preoperative (n = 25) and postoperative (n = 12) patients with isolated sagittal synostosis. Landmark data from 14 landmarks on and around the cranial base were collected from 3-D CT reconstructions and analyzed using Euclidean distance matrix analysis. Subsamples of age-matched patients were used to identify basicranial differences in pre- and postoperative patients and to compare postoperative growth patterns identified in longitudinal data with preoperative growth patterns characterized in cross-sectional data. Results: Statistically significant differences (p ≤ 0.10) were found in the morphology of the cranial base in preoperative and postoperative patients. The relative positions of the landmarks nasion, right asterion, and left asterion are similar in preoperative and postoperative patients. However, the position of these landmarks relative to the cranial base is different in the two groups, being positioned relatively more anteriorly in postoperative patients. In addition, we found that the cranial base angle, on average, neither increases nor decreases in the first postoperative year. These morphological differences are associated with divergent growth trajectories in the operated and unoperated cranial base. Conclusion: Regardless of specific procedure, neurocranial surgery in sagittal synostosis patients affects growth patterns of the cranial base. The lack of change in the postoperative cranial base angle suggests that neurocranial surgery alleviates the occipital rotation and decreased cranial base angle described in the sagittal synostosis basicranium.

Original languageEnglish (US)
Pages (from-to)134-146
Number of pages13
JournalCleft Palate-Craniofacial Journal
Volume38
Issue number2
DOIs
StatePublished - Mar 2001
Externally publishedYes

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Craniosynostoses
Skull Base
Growth
Tomography

Keywords

  • Cranial base
  • Craniosynostosis
  • Euclidean distance matrix analysis (EDMA)
  • Growth

ASJC Scopus subject areas

  • Surgery
  • Dentistry(all)

Cite this

The effect of neurocranial surgery on basicranial morphology in isolated sagittal craniosynostosis. / DeLeon, Valerie Burke; Zumpano, Michael P.; Richtsmeier, Joan T.

In: Cleft Palate-Craniofacial Journal, Vol. 38, No. 2, 03.2001, p. 134-146.

Research output: Contribution to journalArticle

DeLeon, Valerie Burke ; Zumpano, Michael P. ; Richtsmeier, Joan T. / The effect of neurocranial surgery on basicranial morphology in isolated sagittal craniosynostosis. In: Cleft Palate-Craniofacial Journal. 2001 ; Vol. 38, No. 2. pp. 134-146.
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abstract = "Objective: Isolated sagittal craniosynostosis produces a scaphocephalic neurocranium associated with abnormal basicranial morphology, providing additional evidence of the developmental relationship of the neurocranium and basicranium. Corrective surgical procedures vary, but the immediate impact of the surgical procedure is restricted to the neurocranium. This study addresses the secondary effects of neurocranial surgery on the cranial base. Design: Three-dimensional (3-D) computed tomography (CT) scans were obtained for preoperative (n = 25) and postoperative (n = 12) patients with isolated sagittal synostosis. Landmark data from 14 landmarks on and around the cranial base were collected from 3-D CT reconstructions and analyzed using Euclidean distance matrix analysis. Subsamples of age-matched patients were used to identify basicranial differences in pre- and postoperative patients and to compare postoperative growth patterns identified in longitudinal data with preoperative growth patterns characterized in cross-sectional data. Results: Statistically significant differences (p ≤ 0.10) were found in the morphology of the cranial base in preoperative and postoperative patients. The relative positions of the landmarks nasion, right asterion, and left asterion are similar in preoperative and postoperative patients. However, the position of these landmarks relative to the cranial base is different in the two groups, being positioned relatively more anteriorly in postoperative patients. In addition, we found that the cranial base angle, on average, neither increases nor decreases in the first postoperative year. These morphological differences are associated with divergent growth trajectories in the operated and unoperated cranial base. Conclusion: Regardless of specific procedure, neurocranial surgery in sagittal synostosis patients affects growth patterns of the cranial base. The lack of change in the postoperative cranial base angle suggests that neurocranial surgery alleviates the occipital rotation and decreased cranial base angle described in the sagittal synostosis basicranium.",
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