The effect of cranial base surgery on congenital craniofacial deformities

Introduction: The cranial base is a “constructional template” for facial development, normal or abnormal. Craniofacial synostosis involves abnormalities of the sutures of the cranium, the face, and the growth centers of the skull base. In Apert and Crouzon the anterior cranial base are foreshortened and the middle cranial fossae rotated in a more vertical position. In Saethre-Chotzen the asymmetric involvement of coronal suture produces plagiocephaly and facial asymmetry. The authors analyze the effects of the orbital movements on cranial base.

Patients and methods: A retrospective review on a few cases of syndromal Craniofacial Dysostosis (Apert, Crouzon, Saethre-Chotzen, Pfeiffer), HTO, BETS type Syndrome and non-syndromal is reported. The review is based on clinical and CT scans data. The effects of surgical orbital movements on the cranial base are analyzed.

Results: The orbital movements depend on the deformities in the orbital and periorbital area. The orbito-frontal bandeau is the landmark and a key structure in craniofacial surgery. After the movements of the orbits there are deep changes on the size and shape of the cranial base.

Conclusion: Craniosynostosis, isolated or syndromic, occurs with primary or secondary deformities of the cranial base. The orbital skeleton is involved in almost all craniofacial deformities. Surgical three-dimensional displacement of the orbitocranial complex may have deep effect on the shape and size of the cranial base. The craniofacial axis depends on the position of the anterior cranial base and on the interorbital space. In syndromic craniosynostosis the abnormal growth potential remains still a controversial issue.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on The effect of cranial base surgery on congenital craniofacial deformities
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