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The Role of Bone Centers in the Pathogenesis of Craniosynostosis: An Embryologic Approach Using CT Measurements in Isolated Craniosynostosis and Apert and Crouzon Syndromes

Mathijssen, Irene M. J. M.D.; Vaandrager, J. M. M.D.; van der Meulen, J. C. M.D., Ph.D.; Pieterman, H. M.D.; Zonneveld, F. W. Ph.D.; Kreiborg, S. D.M.D., Ph.D.; Vermeij-Keers, C. M.D., Ph.D.

Plastic and Reconstructive Surgery: July 1996 - Volume 98 - Issue 1 - p 17–26
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This paper describes the role of the displacement of bone centers, i.e., the tubers, in the pathogenesis of craniosynostosis. This displacement was studied in 54 patients with isolated or syndromic craniosynostosis in the form of CT scans as well as in two dry neonate skulls with Apert syndrome. For comparison, 49 fetal and 8 normal infant dry skulls were studied. Our investigation was restricted to the coronal and metopic sutures. The results showed a significantly more occipital localization of the frontal bone center and a more frontal localization of the parietal bone center at the side of a synoslotic coronal suture in the isolated form as well as in Apert syndrome. In contrast, this was not the case in Crouzon syndrome, thus showing that these two syndromes have a different pathogenesis. For trigonocephaly, a more anteromedial localization of the frontal bone centers was found.

Rotterdam and Utrecht, The Netherlands, and Copenhagen, Denmark

From the Departments of Plastic and Reconstructive Surgery and Radiology at the Academic Hospital Rotterdam, the Department of Radiology at the Academic Hospital Utrecht, and the Department of Pediatric Dentistry at the University of Copenhagen. Received for publication July 19, 1995.

Chr. Vermeij-Keers, M.D., Ph.D. Department of Anatomy/Plastic and Reconstructive Surgery Academic Hospital Rotterdam Postbus 1738 3000 DR Rotterdam The Netherlands

©1996American Society of Plastic Surgeons