Postoperative change of skull base of craniosynostoses treated by frontorbital advancement by using 3-D digital technique

Abstract

Objective To investigate the deformity of cranial base in patients with craniosynostosis and to evaluate the effect of modified fronto-orbital advancement (FOA) for craniosynostosis using three-dimensional digital technology. Methods From January 2010 to December 2016, 10 cases of craniosynostosis were included in the study. All patients underwent modified FOA, we quantitatively analysed the pre-operative deformity and the surgical outcome of FOA performed in ten patients with craniosynostosis. The measurements of skull base were performed based on 3D computed tomography (CT) scan. We assessed the symmetry of skull base and the deflection of anterior cranial fossa. Results The mean patients＇ age at FOAs was 3.2 years. A significant asymmetry of skull base was found in all patients. The growth of anterior and middle fossae was restricted. On the follow-up CT images 23.6 months after surgery, there was prominent change (P<0.05) between the two hemibases (CSO^ ratio) and between the lengths and angles of anterior and middle cranial hemi-fossae (CX, CSX^, XSM^ratio). Anterior cranial vault asymmetry index obviously decreased from 12.4% to 1.05% before surgery (P<0.05). In addition, anterior cranial vault deflection angle proved to also be less after surgical correction (20.33°±9.19° versus 13.13°±5.28°, P<0.05) . Conclusions The asymmetry of skull base can be presented by intracranial view at over 1 year of age. FOA can correct the skeletal malformation of frontotemporal region and the asymmetry of skull base is improved after surgical treatment. Key words: Craniosynostosis; Morphology of skull base; Fronto-orbital advancement; Three-dimensional digital technology