Objective Unilateral lambdoid synostosis (ULS) is characterized by occipital flattening, mastoid bulging, and contralateral parietal bossing. Anterior craniofacial features are less well-defined. This study utilizes volumetric, craniometric, and composite heat maps of three-dimensional (3D) rendered CT scans to analyze anterior craniofacial asymmetry in ULS and compared to controls. Design A retrospective review of three-dimensional CT scans. Setting Tertiary care pediatric institution. Patients, Participants 30 ULS and 30 control patients. Main Outcome Measure(s) Volumetric and craniometric analysis of the anterior fossa, orbits, zygomas, maxilla, and mandible was performed. Results The anterior fossa volume was greater bilaterally (0.047, 0.038), and the fossa angle was more anterior contralaterally (<0.001) and more anterior bilaterally than controls (0.038, 0.033). The orbits had greater height and lesser depth bilaterally compared to controls (0.006, 0.009; < 0.001, < 0.001). Zygoma length was significantly greater on the contralateral side than controls (0.048; < 0.001). Nasal contralateral deviation of 3.57 +/- 1.97 degrees. The maxillary length was longer on the contralateral side (0.045). The mandibular angle was more anterior on the ipsilateral side and posterior on the contralateral side (<0.001) compared to controls (0.042, < 0.001). Chin had a contralateral deviation of 1.04 +/- 3.74 degrees. Conclusions ULS has significant asymmetry in the anterior craniofacial skeleton. There is a bilateral expansion of the anterior cranial fossa with greater frontal bossing on the contralateral side. Increased orbital height and decreased depth. Contralateral zygomatic and mandibular body lengthening with posterior mandibular deviation. These features may provide more effective diagnosis and potential clinical management strategies.
机构:
Univ Virginia Hlth Syst, Dept Plast Surg, Charlottesville, VA USAUniv Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USA
Akyeampong, Daniel K.
Burke, Rebecca
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Univ Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USAUniv Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USA
Burke, Rebecca
Morgenstern, Peter F.
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Icahn Sch Med Mt Sinai, Dept Neurosurg, New York, NY 10029 USAUniv Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USA
Morgenstern, Peter F.
Keating, Robert F.
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Childrens Natl Med Ctr, Dept Neurosurg, Washington, DC 20010 USAUniv Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USA
Keating, Robert F.
Black, Jonathan S.
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Univ Virginia Hlth Syst, Dept Plast Surg, Charlottesville, VA USAUniv Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USA
Black, Jonathan S.
Jane, John A., Jr.
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Univ Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USAUniv Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USA
Jane, John A., Jr.
Syed, Hasan R.
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Univ Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USAUniv Virginia Hlth Syst, Dept Neurol Surg, POB 800212, Charlottesville, VA 22908 USA
机构:
Erasmus MC, Dutch Craniofacial Ctr, Dept Oral Maxillofacial Surg Special Dent Care & O, Rotterdam, Netherlands
Dutch Craniofacial Ctr, Dept Oral Maxillofacial Surg Special Dent Care & O, Erasmus Med Ctr, POB 2040, NL-3000 CA Rotterdam, NetherlandsErasmus MC, Dutch Craniofacial Ctr, Dept Oral Maxillofacial Surg Special Dent Care & O, Rotterdam, Netherlands
Choi, Tsun Man
Liu, Xianjing
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Erasmus MC, Dutch Craniofacial Ctr, Dept Oral Maxillofacial Surg Special Dent Care & O, Rotterdam, Netherlands
Erasmus MC, Dept Radiol & Nucl Med, Rotterdam, NetherlandsErasmus MC, Dutch Craniofacial Ctr, Dept Oral Maxillofacial Surg Special Dent Care & O, Rotterdam, Netherlands
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Univ Hong Kong, Fac Dent, Oral & Maxillofacial Surg, Hong Kong, Hong Kong, Peoples R ChinaUniv Hong Kong, Fac Dent, Oral & Maxillofacial Surg, Hong Kong, Hong Kong, Peoples R China
Leung, M. Y.
Leung, Y. Y.
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Univ Hong Kong, Fac Dent, Oral & Maxillofacial Surg, Hong Kong, Hong Kong, Peoples R ChinaUniv Hong Kong, Fac Dent, Oral & Maxillofacial Surg, Hong Kong, Hong Kong, Peoples R China