Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery · 2024
A cephalometric study on Le Fort Ⅲ osteotomy related anatomical features of anterior cranial base in syndromic craniosynostosis.
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Liang Jie, Liu Yue, Liu Xiaojing, Zhang Yi, Xu Xiangliang
Аннотация
PURPOSE: This study aims to investigate the anatomical features relating to nasofrontal and septum osteotomy during Le Fort Ⅲ osteotomy among patients with syndromic craniosynostosis, and to compare them with normal controls using computed tomographic cephalometry.
MATERIALS AND METHODS: A total of 63 subjects were included (syndromic craniosynostosis, n = 21; controls, n = 42). The craniosynostosis subjects were subdivided into group A (craniosynostosis patients without history of previous surgery, n = 8) and group B (craniosynostosis patients with history of previous surgery, n = 13). Cephalometric measurements based on computed tomographic images were analyzed.
RESULTS: The angle between the refencing plane (HP) of the anterior cranial base and the most inferior point of the sphenoid sinus via Nasion (∠HP-N-ISS) was 23.85 ± 3.10°, 21.15 ± 4.64° and 28.32 ± 2.92° for group A, group B and the control group, respectively. The angle between HP and the posterior nasal spine (PNS) via nasion (∠HP- N- PNS) was 42.63 ± 2.02°, 38.50 ± 4.84° and 47.68 ± 2.62° for group A, group B and the control group, respectively.
CONCLUSION: This study characterized the surgically relevant anatomical features in nasofrontal osteotomy during Le Fort Ⅲ osteotomy. The safe range for osteotomy angle is significantly different between normal and syndromic craniosynostosis subjects. Awareness of this difference may prevent further complications.
MATERIALS AND METHODS: A total of 63 subjects were included (syndromic craniosynostosis, n = 21; controls, n = 42). The craniosynostosis subjects were subdivided into group A (craniosynostosis patients without history of previous surgery, n = 8) and group B (craniosynostosis patients with history of previous surgery, n = 13). Cephalometric measurements based on computed tomographic images were analyzed.
RESULTS: The angle between the refencing plane (HP) of the anterior cranial base and the most inferior point of the sphenoid sinus via Nasion (∠HP-N-ISS) was 23.85 ± 3.10°, 21.15 ± 4.64° and 28.32 ± 2.92° for group A, group B and the control group, respectively. The angle between HP and the posterior nasal spine (PNS) via nasion (∠HP- N- PNS) was 42.63 ± 2.02°, 38.50 ± 4.84° and 47.68 ± 2.62° for group A, group B and the control group, respectively.
CONCLUSION: This study characterized the surgically relevant anatomical features in nasofrontal osteotomy during Le Fort Ⅲ osteotomy. The safe range for osteotomy angle is significantly different between normal and syndromic craniosynostosis subjects. Awareness of this difference may prevent further complications.