How does nonsyndromic craniosynostosis affect on bone width of nasal cavity in children? - Computed tomography study.

Katarzyna Gruszczyńska,Zbigniew Olczak,Marek Mandera,Kamila Gołdyn,Magdalena Onyszczuk,Magdalena Machnikowska-Sokołowska,Wirginia Likus,Jan Baron,Rita Wawruszczak,James J Cray

doi:10.1371/journal.pone.0200282

Katarzyna Gruszczyńska, Zbigniew Olczak + Show 8 more

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https://doi.org/10.1371/journal.pone.0200282

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Abstract

Craniosynostosis is caused by premature fusion of one or more cranial sutures, restricting skull, brain and face growth. Nonsyndromic craniosynostosis could disturb the proportions of face. Although morphometric diameters of nasal cavity in healthy children are already known, they have not been established yet in children with nonsyndromic craniosynostosis. The aim our study was to check whether diameters of bone structures of nasal cavity in children with nonsyndromic craniosynostosis measured in CT are within normal range. 249 children aged 0–36 months (96 with clinical diagnosis of nonsyndromic craniosynostosis and 153 in control group) were included into the study. The following diameters were measured on head CT scans: anterior bony width (ABW), bony choanal aperture width (BCAW), right and left posterior bony width (between bone sidewall and nasal cavity septum—RPBW and LPBW). The study group has been divided into 4 categories, depending on child’s age. The dimensions measured between bone structures of nasal cavity were statistically significantly lower in comparison to the control group. They did not depend on the sex for ABW, nor on age in groups 7–12 months and < 2 years for BCAW, RPBW and LPBW. The measured dimensions increased with age. In children with nonsyndromic craniosynostosis the diameter of pyriform aperture and bony choanal aperture were lower than in controls, what may be described as fronto-orbital anomalies. Morphometric measurements of anthropometric indicators on CT scans could be used as standards in the clinical identification of craniosynostosis type and may help in planning surgical procedures, particularly in the facial skeleton in children.

Highlights

Craniosynostosis, a pathologic fusion of calvarial bones that is associated with an abnormal skull growth, was first described in 1830 by Otto [1]
The goal of the present study was to check whether the diameters of bone structures of nasal cavity in children with nonsyndromic craniosynostosis measured in CT are within this normal range
The second reason for division of both children groups into four narrow age categories was to perform a more precise comparison of studied morphological parameters reducing the potential influence of aging and growth

Summary

Introduction

Craniosynostosis, a pathologic fusion of calvarial bones that is associated with an abnormal skull growth, was first described in 1830 by Otto [1]. It is a congenital disorder, most often (60–80%) presenting itself either as a nonsyndromic (isolated) feature, or as a part of Apert, Crouzon or Pfeiffer syndrome. Craniosynostosis is controlled by several genetic mutations involving transcription factor, growth factor receptor and cytokine expression These numerous factors are associated with premature suture fusion [4,5,6,7]. The goal of the present study was to check whether the diameters of bone structures of nasal cavity in children with nonsyndromic craniosynostosis measured in CT are within this normal range. The second reason for division of both children groups (controls and those suffering from nonsyndromic craniosynostosis) into four narrow age categories was to perform a more precise comparison of studied morphological parameters reducing the potential influence of aging and growth

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