A cephalometric study on Le Fort Ⅲ osteotomy related anatomical features of anterior cranial base in syndromic craniosynostosis

• Published in: Journal of cranio-maxillo-facial surgery Vol. 52; no. 11; pp. 1406 - 1410
• Main Authors: Liang, Jie, Liu, Yue, Liu, Xiaojing, Zhang, Yi, Xu, Xiangliang
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.11.2024
• Subjects: Adolescent; Anterior cranial-base anatomy; Case-Control Studies; Cephalometry - methods; Child; Craniosynostoses - diagnostic imaging; Craniosynostoses - surgery; Female; Humans; Male; Osteotomy, Le Fort - methods; Skull Base - diagnostic imaging; Skull Base - surgery; Syndrome; Syndromic craniosynostosis; Three-dimensional cephalometry; Tomography, X-Ray Computed; Young Adult; Syndromic craniosynostosis; Three-dimensional cephalometry; Anterior cranial-base anatomy
• ISSN: 1010-5182; 1878-4119; 1878-4119
• DOI: 10.1016/j.jcms.2024.02.005

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. 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. 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. 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.