Evaluatin of Staggered Osteotomy in Surgical Treatment of Trigonocephaly

Seyed Esmail Hassanpour, Seyed Mahdi Moosavizadeh, Mohammad Reza Hadi Sichani, Hamidreza Alizadeh Otaghvar, Mohammadreza Tarahomi, Daryanaz Shojaei, Amir Molaei, Leili Mohajerzadeh

Abstract


276

 Background: undiagnosed metopic synostosis (Trigonocephaly) have many complications for infant such as Brian damage and cognitive & behavioral disorders also aesthetic malformations.There are a lot of surgical techniques for it that have their advantages and disadvantages but with this new method we can solve some of these problems and minimize damages.

Method:  In this study, 45 infants with Metopicsynostosis underwent surgery in Tehran Mofid Hospital.  The Minimum of age were 4 months  and Maximum 9 months with average of 6.72 months .Our cases in this study are infants with trigonicephaly that their diagnosis is confirmed with clinical symptoms & signs also with CTScan and paraclinical findings. The most common classification of surgical revision of Craniosynostosis  named Whitaker, has been c as follows.

Results: After analysis in this study we find significant differences in anthropometric indeces before & after surgery such as lowering of biparietal width after surgery and elevating of frontoparital index after surgery. As in this procedure, we don’t separate the frontal bone segments and it keeps its frame , so less plaques and screws are needed which will decrease the costs of the surgery and the surgical time is much more fewer than the other techniques.And last but not the least, the satisfactions of parents were high and there was no need for secondary surgery.

Conclusion: Based on all the perfect results we got , it is safe to say that,Staggered osteotomy as a surgical method for correction of trigonocephaly is useful method and we can use it as a new method in correction of  metopic synostosis.


Keywords


Metopic, synostosis, Trigonocephaly, Staggered osteotomy

Full Text:

PDF

177

References


Graham, J.M., Jr, deSaxe, M. and Smith,D.W. (1979) Sagittal craniostenosis:fetal head constraint as one possible cause. J. Pediatr., 95, 747–750

Wilkie Ao:Molecuvlar genetics of craniosynostosis in link K y,oyle Rc,Jane JA: Craniofacial surgery. Philadelphia,WB Saunders,2001:41-54

Hunter, A.G.W. and Rudd, N.L. (1976) Craniosynostosis. I. Sagittal synostosis; its genetics and associated clinical findings in 214 patients who lacked involvement of the coronal suture(s). Teratology, 14, 185–194.

Hunter, A.G.W. and Rudd, N.L. (1977) Craniosynostosis. II. Coronal synostosis: its familial characteristics and associated clinical findings in 109 patients lacking bilateral polysyndactyly or syndactyly. Teratology, 15, 301–310.

Virchow R. Ueber den Cretinismus, namentlich in Franken, und überpathologischeSchädelformen. VerhPhysikalisch Med GesWürzburg. 1851. 2:230-71.

Frassanito P, Di Rocco C. Depicting cranial sutures: a travel into the history. Childs Nerv Syst. 2011 Aug. 27(8):1181-3.

Tessier P. [Total facial osteotomy. Crouzon's syndrome, Apert's syndrome: oxycephaly, scaphocephaly, turricephaly]. Ann ChirPlast. 1967 Dec. 12(4):273-86.

Jane JA, Edgerton MT, Futrell JW, Park TS. Immediate correction of sagittal synostosis, 1978. J Neurosurg. 2007 Nov. 107(5 Suppl):427-32.

Bonnier L, Ayadi K, Vasdev A, et al. Three-dimensional reconstruction in routine computerized tomography of the skull and spine. Experience based on 161 cases. J Neuroradiol. 1991. 18(3):250-66

Darling CF, Byrd SE, Allen ED, et al. Three-dimensional computed tomography imaging in the evaluation of craniofacial abnormalities. J Natl Med Assoc. 1994 Sep. 86(9):676-80.

Kreiborg S, Marsh JL, Cohen MM Jr, et al. Comparative three-dimensional analysis of CT-scans of the calvaria and cranial base in Apert and Crouzon syndromes. J Craniomaxillofac Surg. 1993 Jul. 21(5):181-8.

Marsh JL, Vannier MW. The anatomy of the cranio-orbital deformities of craniosynostosis: insights from 3-D images of CT scans. ClinPlast Surg. 1987 Jan. 14(1):49-60.

Marsh JL, Vannier MW. Three-dimensional surface imaging from CT scans for the study of craniofacial dysmorphology. J Craniofac Genet Dev Biol. 1989. 9(1):61-75.

Crouzon O. Dysostosecranio-facialehéréditaire. Bull MemSoc Med Hop Paris. 1912. 33:545-55.

Apert E, Bigot A. Dysostosecranio-facialehereditaire(type Crouzon) (presentation de malades). Bull MemSoc Med Hop Paris. 1921. 45:1717-9.

Apert E. l'acrocephalosyndactylie. Bull MemSoc Med Hop Paris. 1906. 23:1310.

Persing JA, Jane JA, Shaffrey M. Virchow and the pathogenesis of craniosynostosis: a translation of his original work. PlastReconstr Surg. 1989 Apr. 83(4):738-42

Frassanito P, Di Rocco C. Depicting cranial sutures: a travel into the history. Childs Nerv Syst. 2011 Aug. 27(8):1181-3

Lajeunie, E., Le Merrer, M., Bonaïti-Pellie, C., Marchac, D. and Renier, D.

(1995) Genetic study of nonsyndromic coronal craniosynostosis. Am.J.Med. Genet., 55, 500–504.

Lajeunie, E., Le Merrer, M., Bonaïti-Pellie, C., Marchac, D. and Renier, D.

(1996) Genetic study of scaphocephaly. Am. J. Med. Genet., 62, 282–285.

Renier, D., Sainte-Rose, C., Marchac, D. and Hirsch, J.-F. (1982) Intracranial

pressure in craniostenosis. J. Neurosurg., 57, 370–377.

David, L.R., Wilson, J.A., Watson, N.E. and Argenta, L.C. (1996) Cerebral perfusion defects secondary to simple craniosynostosis. J. Craniofac. Surg., 7, 177–185.

Gosain, A.K., McCarthy, J.G. and Wisoff, J.H. (1996) Morbidity associated withincreased intracranialpressure in ApertandPfeiffer syndromes:the need for long-term evaluation. Plastic Reconstr. Surg., 97, 292–301.

Gonsalez, S., Hayward, R., Jones, B. and Lane, R. (1997) Upper airway obstruction and raised intracranial pressure in children with craniosynostosis. Eur. Respir. J., 10, 367–375.

Opperman, L.A., Passarelli, R.W., Nolen, A.A., Gampper, T.J and Ogle, R.C.

(1996) Dura mater secretes soluble heparin-binding factors required for cranial suture morphogenesis. In Vitro Cell. Dev. Biol., 32, 627–632

Cohen, M.M., Jr (1993) Sutural biology and the correlates of craniosynostosis. Am. J. Med. Genet., 47, 581–616

Cohen, M.M., Jr. (1986) In Cohen, M.M., Jr (ed.) Craniosynostosis: Diagnosis, Evaluation and Management. Raven Press, New York, pp. 413–590

Winter, R.M. and Baraitser, M. (1996) The London Dysmorphology Database. Oxford University Press, Oxford

Wilkie, A.O.M., Morriss-Kay, G.M., Jones, E.Y. and Heath, J.K. (1995) Functions of fibroblast growth factors and their receptors. Curr. Biol., 5, 500–507

Ramirez, F. (1996) Fibrillin mutations in Marfan syndrome and related

phenotypes. Curr. Opin. Genet. Dev., 6, 309–315.

Welcker H. Untersuchungenuber wachstum und bau des menschlichenschadels.Leipzig:Engelmann,1862:120-4.

LajeunieE.LeMerrer, MarchacD,Renier D:Syndrome and nonsyndromal primary trigonocephaly:analysis of a series of 237 patients. Am J Med Genet 1998;75:211-215

Da Costa AC, Anderson VA, Savarirayan R, Wrennall JA, Chong DK, Holmes AD. Neurodevelopmental functioning of infants with untreated single-suture craniosynostosis during early infancy. Childs Nerv Syst. 2012 Jun. 28(6):869-77

Dimopoulos VG, Kapsalakis IZ, Fountas KN. Skull morphology and its neurosurgical implications in the Hippocratic era. Neurosurg Focus. 2007. 23(1):E10

Delashaw JB, Persing JA, Jane JA. Cranial deformation in craniosynostosis. A new explanation. NeurosurgClin N Am. 1991 Jul. 2(3):611-20.

Hoyte DA. The cranial base in normal and abnormal skull growth. NeurosurgClin N Am. 1991 Jul. 2(3):515-37.

deGrouchyJ,TurleauC.Atlasdesmaladieschromosomiques. 2nded.Paris:ExpansionScientifiqueFrangaise,1982.

BorgaonkarDS.Chromosomalvariationinman. Acatalogof chromosomalvariantsandanomalies.3rded.NewYork:Liss, 1980.

Reproduced from Whitaker LA,BartiettSP,SchutL,etal.Craniosynostosis :analysis of the timing , treatment,and complications in 164 consecutivepatients. PlastReconstrSurg 1987;80:195

OpitzJM,JohnsonRC,McCreadieSR,Smith DW. The C syndromeofmultiplecongenitalanomalies. BirthDefects 1969;V(2):161-6

PreusM, AlexanderWJ,FraserFC.The'C'syndrome.Birth Defects1975;XI(2):58-62.

OberklaidF,DanksDM.TheOpitztrigonocephalysyndrome: a case report. Am JDisChild1975;129:1348-9

Antley RH, Do Sung Hwang, Theopold W, etal.Further delineationofthe C (trigonocephaly)syndrome. Am J Med Genet1981;9:147-63.

Fearon JA, Ko large JC,MunroIR:trigonocephaly-associated hypotelorism:is treatment necessary?Plast Reconst Surg. 1996.97;503-509

PashleyDH.Broke JL Biome chances and craniofacial morphogenesis, diagnosis, Evaluation and Management.New York , Oxford University Press 2000:84-100

KelherMO,MurrayDJ,McGilivaryA,KamalMH,Alleult D,Earley MJ. Nonsyndromic trigonocephaly :surgical decision making and long-term cosmetic results.Childs Nervous System. 2007 Nov ;23 (11):1285-9.Epub 2007 June 14.

Posnick, Jeffrey C. D.M.D., M.D.; Lin, Kant Y. M.D.; Chen, Phillip M.D., and; Armstrong, Derek M.B., B.S., F.R.C.P.(C)Metopic Synostosis: Quantitative Assessment of Presenting Deformity and Surgical Results Based on CT Scans.Plastic & Reconstructive Surgery 1994 Jan ;93 (1):16-24

John C. Kolar1,* andE. M. Salter2 Preoperative anthropometric dysmorphology in metopic synostosis American Journal of physical anthropology 1997;103:341-351

Cohen, Steven R. M.D.; Maher, Hazem M.D.; Wagner, Jeffrey D. M.D.; Dauser, Robert C. M.D.; Newman, M. Haskell M.D.; Muraszko, Karin M. M.D.Metopic Synostosis: Evaluation of Aesthetic Results.cneter for craniofacial disorders ,Scottish Rite children's hospital,Atlanta,GA .Plastic & Reconstructive Surgery1994;94 (6):759-67




DOI: https://doi.org/10.22037/irjps.v3i1.17294

Refbacks

  • There are currently no refbacks.