Detalle Publicación


Investigating the cause of late deformity following fronto-orbital remodelling for metopic synostosis using 3DCT imaging

Autores: Rodríguez Florez, Naiara; Flórez Tapia, Ane Miren; Jeelani, N.U.O.; Schievano, S.; Dunaway, D.J.; Hayward, R.D. (Autor de correspondencia)
ISSN: 1010-5182
Volumen: 47
Número: 1
Páginas: 170 - 178
Fecha de publicación: 2019
Purpose Late deformity/indentation is well-recognised following fronto-orbital remodelling (FOR) for metopic synostosis. We hypothesise that if damage to temporalis muscle were a contributor, the thickness of soft tissue and bone in the affected area would be reduced. Materials and methods Soft tissues and bone were separately segmented and reconstructed three-dimensionally from computed tomograms of 8 patients 1.5¿18 years post-FOR performed at 16 ± 2 months for metopic synostosis and from 8 age-matched controls. Soft tissue (taken as proxy for temporalis muscle) and bone thickness overall and in the indented areas were computed. Results Post-FOR, three-dimensional soft tissue thickness maps demonstrated temporalis extending upwards but falling short of the indented area. Overall skull thickness increased with age post-FOR (logarithmic fit R2 = 0.71) and for controls (R2 = 0.90). Although immediately post-FOR the future indented area had a thickness of 98% of control, it decreased linearly to 64% 16 years later (Pearson's r = 0.84). Conclusion These findings suggest that late post-FOR deformity/indentation is enhanced by limited upward extension (or retraction downwards) of temporalis muscle, while bone thickness in the affected area gradually decreases. This supports the hypothesis that aberrant re-attachment of the temporalis muscle makes a material contribution to late deformity following FOR for metopic synostosis.