title: Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly.
abstract: OBJECTIVE
  The study aimed to identify premature synostosis of "major" and "minor" sutures of the coronal sutural arch and splanchnocranium sutures to evaluate the relationship between craniofacial dysmorphology and the sutural pattern in children with anterior plagiocephaly.
  
  
  METHODS
  A quantitative analysis of the skull base and facial changes was performed on preoperative high-resolution CT images in 18 children with anterior synostotic plagiocephaly and compared with imaging findings in 18 age-matched healthy subjects.
  
  
  RESULTS
  All patients had patent splanchnocranium sutures. Fifteen out of 18 children showed early and isolated synostosis of the unicoronal suture (the major suture of the coronal ring) and were classified in groups II and III according to the classification scheme of anterior synostotic plagiocephaly based on the severity of craniofacial dysmorphology. Premature fusion of the unilateral coronal suture in groups II and III caused a marked asymmetry and reduced growth of the anterior and middle fossae on the synostotic side and a secondary varying severity in terms of asymmetric growth of the facial complex. Although both groups showed anterior displacement of the mandibular articulation on the synostotic side, group II showed only maxillary asymmetry, while group III showed maxillary and mandibular asymmetry.
  
  
  CONCLUSIONS
  In anterior synostotic plagiocephaly, the severity of skull base changes and asymmetric growth of the facial complex is not caused by skull base sutural synostotic involvement but is probably related to the different timing of unilateral coronal suture closure.
authors.affiliation: Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy. rocalan1@virgilio.it.
authors.forename: Rosalinda
authors.initials: R
authors.lastname: Calandrelli
authors.affiliation: Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: D'Apolito
authors.affiliation: Istituto di Neurochirurgia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Massimi
authors.affiliation: Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Gaudino
authors.affiliation: Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Visconti
authors.affiliation: Istituto di Chirurgia Maxillo-Facciale, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Pelo
authors.affiliation: Istituto di Neurochirurgia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Concezio
authors.initials: C
authors.lastname: Di Rocco
authors.affiliation: Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Colosimo
mesh_terms: D003393:Cranial Sutures / Q000000981:diagnostic imaging*; D003398:Craniosynostoses / Q000000981:diagnostic imaging*; D005145:Face / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D012886:Skull / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
keywords: Craniostenosis; Facial asymmetry; High-resolution CT; Skull base alterations