Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly

Abstract

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.

Anterior Synostotic Plagiocephaly: A Quantitative Analysis of Craniofacial Features Using Computed Tomography

“…On the other hand, the angle of the ACF decreased significantly on the ipsilateral side as compared with the contralateral side by an average difference of −19.0% (Supplemental Table 2, Supplemental Digital Content 1, http://links.lww.com/SCS/E170). Calandrelli et al,3 Captier et al,10 Calandrelli et al,16 and Marsh et al17 also noted this significant trend. Since growth perpendicular to the suture is inhibited, these results could be attributed to the ipsilateral flattening of the frontal bone, including the SOR.…”

“…Previous research that focused on orbital volume employed their desired orbital boundaries when segmenting the orbital cavity to compute the volume. Despite this, these investigations found a similar pattern; the volume of the orbit on the ipsilateral and contralateral sides differed significantly, with the volume on the ipsilateral orbit being smaller than the volume on the contralateral orbit 3,16,18–20. Since Calandrelli et al3 classified their patients using the Di Rocco and Velardi15 classification scheme, they found a steady decrease in the volume on the ipsilateral orbits as the severity of ASP increased.…”

“…Deviation of the facial structures is also attributed to the asymmetry in the skull base. 6,16 There is also a notion that most forms of craniosynostosis have their origin in deformities in the skull base. 16 Because of the relatively small numbers of ASP cases in single institutions, only a few previous studies quantitatively reported on the asymmetry of craniofacial structures.…”

“…6,16 There is also a notion that most forms of craniosynostosis have their origin in deformities in the skull base. 16 Because of the relatively small numbers of ASP cases in single institutions, only a few previous studies quantitatively reported on the asymmetry of craniofacial structures. Many variables of these asymmetric craniofacial features (for example, ACF width, length of curvature, volume, and height; orbital length and surface area; and position of the ears) are not included in the literature and have yet to be reported on.…”

“…Many variables of these asymmetric craniofacial features (for example, ACF width, length of curvature, volume, and height; orbital length and surface area; and position of the ears) are not included in the literature and have yet to be reported on.3,8 In terms of the ACF, the length was measured, and it was observed that the ipsilateral side was shorter than the contralateral side, resulting in a significant difference.3,10,16 The ipsilateral and contralateral ACF angles were also significantly different; the ipsilateral angle was smaller since it is usually more acute than the contralateral angle. The asymmetry of the ACF was caused by these substantial differences in ACF lengths and angles, which resulted in decreased growth on the ipsilateral side and increased growth on the contralateral side 3,10,16,17…”