Positive Impact of Frontofacial Advancement on Intracranial Volumes in Patients With Syndromic Craniofaciosynostosis.

BACKGROUND

Le Fort (LF) III midface distraction osteogenesis is one of the main techniques for correcting midface deficiency encountered in craniofaciosynostosis. However, regardless of the technique used, there may be a deterioration in the result, with a recurrence of facial hypoplasia, requiring a new procedure to advance the midface.

METHODS

In this retrospective study, computed tomography scans before and after LF III distraction osteogenesis of 7 patients (3 boys and 2 girls with Crouzon syndrome, 1 boy with Apert syndrome, and 1 boy with Pfeiffer syndrome) were analyzed in vestibular orientation. The ages ranged from 4 to 11 years old. All patients presented with syndromic craniofaciosynostosis with class III malocclusion and proptosis. The 3 cranial fossae were segmented slice by slice, and their volumes were calculated. The total intracranial volume was calculated by summing the volumes of the 3 cranial fossae. The Wilcoxon signed-rank test was used to compare the measured values before and after LF III distraction. A P value of less than 0.05 was considered statistically significant.

RESULTS

Total intracranial volume significantly increased (6%; P = 0.016) in the total study group. Volumes of the anterior and middle cranial fossae increased insignificantly (22.6%, P = 0.33; 4.8%, P = 0.29). The volume of the posterior cranial fossae insignificantly decreased (0.3%, P = 0.58).

CONCLUSIONS

A significant increase in total intracranial volume after LF III advancement in syndromic craniofaciosynostosis patients was reported.