[Modern imaging of craniofacial malformations].
Due to progress in the field of medical imaging of craniofacial malformations, the place of these investigations in the assessment of these abnormalities needs to be revised. 3D CT scan currently remains the fundamental element of the assessment by providing a truly anatomical dissection of each bone. In the field of craniostenoses, the study of the base of the skull has allowed a new assessment of lesions of skull base and craniofacial sutures and the resulting skeletal deformities: they provide restrospective justification for an extensive approach to the surgery of this group of malformations and a basis for reflection concerning extension to direct skull base surgery. Craniofacial clefts constitute a heterogeneous groupe of anomalies in which Tessier's concepts have allowed a methodical approach. 3D CT allows better definition of certain subgroups of malformations within this group (midfacial clefts) and provides a clearer understanding of the skeletal defects of maxillary clefts, especially in the laterofacial region. This imaging is currently undergoing rapid development. Improvement of 3D CT scanning techniques (direct 3D image acquisition, improvement of the images obtained), development and combination of 3D MRI, after being superimposed onto the skeletal image, will allow total dissection of the malformation. Development of 3D cephalometric analysis techniques and growth analysis software will allow really predictive "image-assisted surgery". Finally, antenatal imaging (B-mode and 3D ultrasonography) makes a considerable contribution to this field of anomalies by allowing the diagnosis of serious or severely disabling anomalies and by elucidating the antenatal development of certain anomalies (especially craniostenoses) and their consequences.
Unité de Chirurgie Plastique Infantile, CHU, Hôpital Lapeyronie, Montpellier, France.
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Montoya
D002508:Cephalometry; D019465:Craniofacial Abnormalities / Q000175:diagnosis*; D005544:Forecasting; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D016216:Ultrasonography, Prenatal
Imagerie moderne des malformations cranio-faciales.