편측관상봉합 조기유합증 환자에서 컴퓨터단층촬영을 이용한 두개 기저부의 술후 변화 예측

Abstract

Craniosynostosis produces not only neurocranial deformity but also cranial base deformity. Previous studies that were focused on the growth of cranial base in craniosynostosis were morphological studies, so they could not report the objective data of measurement, because of the lack of the standardized measurement method. Authors have studied the postoperative changes in growth of the cranial base in craniosynostosis patients by measurement of the distances and angle in the evenly oriented axial slices in pre-operative and postoperative computed tomography (CT). Three unilateral craniosynostosis (plagiocephaly) patients who had undergone the cranial vault surgery in 4,9,18 months after birth were evaluated. The CT scans were obtained with high resolution. The CT scan data were reconstructed three dimensionally via Analyze AVW software, and visualized as volume rendering mode. The reconstructed volume data was realigned using 4 anatomical landmarks, nasion, basion, left and right external auditory meatus. After all data sets were realigned with same orientation, the target axial slice was obtained. The target slices are determined that is passing the center of the sellar trucica. The anterior, posterior and lateral distances were measured and the midsagittal angles were measured on the selected target slices. The pre- and post-operative data of measurement were compared. As results, the growth of affected side was seemed to be more rapid than that of normal side in patients who had undergone surgery at the time of 4 and 9 months old. Midsagittal angle was also increased up to about 180 degrees. However it was not definite in the 18month old patient. These results can be an evidence of the compensatory growth of the synostotic cranial base of synostosed side as same as other previous reports, however, much more cases should be examined to make the results to be more objective.