Plagiocephaly: Morphometry of Skull Base Asymmetry

Overview

Journal Surg Radiol Anat

Specialties Anatomy & Histology
General Surgery
Radiology

Date 2003 Sep 25

PMID 14504821

Citations 18

Authors

G Captier

N Leboucq

M Bigorre

F Canovas

F Bonnel

A Bonnafe

P Montoya

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to perform a morphometric analysis of the skull base to understand the mechanism of asymmetry between malformational and deformational plagiocephaly. Since 1988, we have carried out 102 CT scans with three-dimensional reconstruction of the endocranial side of the skull base. There were 20 cases of malformational plagiocephaly, consisting of 18 unicoronal synostoses (UCS) and two unilambdoid synostoses (ULS), and 82 cases of plagiocephaly without synostosis, made up of 60 cases of frontal plagiocephaly (FP) and 22 of occipital plagiocephaly (OP). The skull base asymmetry was analyzed in three ways: (1) the hemibases and the cranial fossa angles were compared with each other; (2) the structural asymmetry of the chondrocranium was calculated; and (3) the architectural asymmetry was measured in relation to the medio-labyrinthine plane. The skull base asymmetry of malformational plagiocephaly was located in the anterior and middle cranial fossae for UCS and in the posterior and middle cranial fossae for ULS. The asymmetry was the result of a localized structural anomaly of the chondrocranium. The asymmetry of deformational plagiocephaly corresponded to a distortion in relation to the medio-labyrinthine plane while the chondrocranium remained symmetric. The skull base asymmetry of malformational plagiocephaly is secondary to a localized malformation of the chondrocranium, and that of the deformational plagiocephaly is secondary to an architectural deformation.

Citing Articles

Three-Dimensional Analysis of the Cranial Base Structure in Patients with Facial Asymmetry.

Hayashi Y, Tachiki C, Morikawa T, Aihara Y, Matsunaga S, Sugahara K Diagnostics (Basel). 2024; 14(1).

PMID: 38201333 PMC: 10795710. DOI: 10.3390/diagnostics14010024.

Can Craniosynostosis be Diagnosed on Physical Examination? A Retrospective Review.

Zavala C, Zima L, Greives M, Fletcher S, Shah M, Miller B J Craniofac Surg. 2023; 34(7):2046-2050.

PMID: 37646354 PMC: 10592286. DOI: 10.1097/SCS.0000000000009686.

Pdgfra regulates multipotent cell differentiation towards chondrocytes via inhibiting Wnt9a/beta-catenin pathway during chondrocranial cartilage development.

Bartoletti G, Dong C, Umar M, He F Dev Biol. 2020; 466(1-2):36-46.

PMID: 32800757 PMC: 7494641. DOI: 10.1016/j.ydbio.2020.08.004.

Three-dimensional computed tomography evaluation of craniofacial characteristics according to lateral deviation of chin.

Choi H, Kim B, Kim J, Huh J, Park K Maxillofac Plast Reconstr Surg. 2019; 41(1):57.

PMID: 31867294 PMC: 6898705. DOI: 10.1186/s40902-019-0241-1.

The Effects of Helmet Therapy Relative to the Size of the Anterior Fontanelle in Nonsynostotic Plagiocephaly: A Retrospective Study.

Kim D, Lee J, Lee J, Yang J, Chung H, Cho B J Clin Med. 2019; 8(11).

PMID: 31739516 PMC: 6912406. DOI: 10.3390/jcm8111977.

References

Kane A, Mitchell L, Craven K, Marsh J . Observations on a recent increase in plagiocephaly without synostosis. Pediatrics. 1996; 97(6 Pt 1):877-85. View

Bruneteau R, Mulliken J . Frontal plagiocephaly: synostotic, compensational, or deformational. Plast Reconstr Surg. 1992; 89(1):21-31; discussion 32-3. View

Lo L, Marsh J, Pilgram T, Vannier M . Plagiocephaly: differential diagnosis based on endocranial morphology. Plast Reconstr Surg. 1996; 97(2):282-91. DOI: 10.1097/00006534-199602000-00003. View

Di Rocco C, Velardi F . Nosographic identification and classification of plagiocephaly. Childs Nerv Syst. 1988; 4(1):9-15. DOI: 10.1007/BF00274074. View

Mulliken J, Vander Woude D, Hansen M, LaBrie R, Scott R . Analysis of posterior plagiocephaly: deformational versus synostotic. Plast Reconstr Surg. 1999; 103(2):371-80. DOI: 10.1097/00006534-199902000-00003. View

Leboucq N, Montoya P, Martinez Y, Castan P . [3D imaging and pathology of the base of the skull in children]. Ann Radiol (Paris). 1992; 35(6):424-9. View

Marsh J, Vannier M . The "third" dimension in craniofacial surgery. Plast Reconstr Surg. 1983; 71(6):759-67. DOI: 10.1097/00006534-198306000-00002. View

Czorny A, Ricbourg B . [The posterior cranium and its dysmorphisms]. Ann Chir Plast Esthet. 1998; 42(5):515-36. View

Rekate H . Occipital plagiocephaly: a critical review of the literature. J Neurosurg. 1998; 89(1):24-30. DOI: 10.3171/jns.1998.89.1.0024. View

10.

. Plagiocephaly and torticollis in young infants. Lancet. 1986; 2(8510):789-90. View

11.

Ferre J, Chevalier C, Robert R, Le Cloarec A, BARBIN J . Reflections on the mechanical structure of the base of the skull and of the face. Part 2: Discussion, current concepts and theories. Surg Radiol Anat. 1989; 11(2):135-40. DOI: 10.1007/BF02096470. View

12.

Loomis M, Radkowski M, Pensler J . Maxillary deformation in unilateral coronal synostosis. J Craniofac Surg. 1990; 1(2):73-6. DOI: 10.1097/00001665-199001020-00001. View

13.

Marsh J, Gado M, Vannier M, Stevens W . Osseous anatomy of unilateral coronal synostosis. Cleft Palate J. 1986; 23(2):87-100. View

14.

Medina L . Three-dimensional CT maximum intensity projections of the calvaria: a new approach for diagnosis of craniosynostosis and fractures. AJNR Am J Neuroradiol. 2000; 21(10):1951-4. PMC: 7974281. View

15.

Montoya P . [Modern imaging of craniofacial malformations]. Ann Chir Plast Esthet. 1998; 42(5):365-99. View

16.

Genitori L, Zanon N, Denis D, Erdincler P, Achouri M, Lena G . The skull base in plagiocephaly. Childs Nerv Syst. 1994; 10(4):217-23. DOI: 10.1007/BF00301157. View

17.

Delaire J, Billet J, Ferre J, Faucher O, Julia P . [Facial malformations and asymmetry of the base of the skull. (A new malformation syndrome interesting from the orthodontic viewpoint)]. Revue Stomatol. 1965; 66(7):379-96. View

18.

Kane A, Lo L, Vannier M, Marsh J . Mandibular dysmorphology in unicoronal synostosis and plagiocephaly without synostosis. Cleft Palate Craniofac J. 1996; 33(5):418-23. DOI: 10.1597/1545-1569_1996_033_0418_mdiusa_2.3.co_2. View

19.

Clarren S, Smith D, Hanson J . Helmet treatment for plagiocephaly and congenital muscular torticollis. J Pediatr. 1979; 94(1):43-6. DOI: 10.1016/s0022-3476(79)80347-9. View

20.

Burdi A, Kusnetz A, Venes J, Gebarski S . The natural history and pathogenesis of the cranial coronal ring articulations: implications in understanding the pathogenesis of the Crouzon craniostenotic defects. Cleft Palate J. 1986; 23(1):28-39. View