Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment
Background:. Unilateral lambdoid craniosynostosis is differentiated from deformational plagiocephaly primarily by assessing the cranium from posterior and bird’s-eye views. Findings include posterior displacement of the ipsilateral ear, ipsilateral occipitomastoid bossing, ipsilateral occipitopariet...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-05-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005011 |
| _version_ | 1797792109158203392 |
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| author | Jonathan Lee, MD Sanjay Naran, MD Daniel Mazzaferro, MD Ari Wes, MD Erin E. Anstadt, MD Jesse Taylor, MD Jesse Goldstein, MD Scott Bartlett, MD Joseph Losee, MD |
| author_facet | Jonathan Lee, MD Sanjay Naran, MD Daniel Mazzaferro, MD Ari Wes, MD Erin E. Anstadt, MD Jesse Taylor, MD Jesse Goldstein, MD Scott Bartlett, MD Joseph Losee, MD |
| author_sort | Jonathan Lee, MD |
| collection | DOAJ |
| description | Background:. Unilateral lambdoid craniosynostosis is differentiated from deformational plagiocephaly primarily by assessing the cranium from posterior and bird’s-eye views. Findings include posterior displacement of the ipsilateral ear, ipsilateral occipitomastoid bossing, ipsilateral occipitoparietal flattening, contralateral parietal bossing, and contralateral frontal bossing. Diagnosis based off facial morphology may be an easier approach because the face is less obstructed by hair and head-coverings, and can easily be assessed when supine. However, frontofacial characteristics of unilateral lambdoid craniosynostosis are not well described.
Methods:. A retrospective cohort review of patients with isolated, unilateral lambdoid craniosynostosis from the Children’s Hospital of Pittsburgh and the Children’s Hospital of Philadelphia was performed. Preoperative frontal and profile photographs were reviewed for salient characteristics.
Results:. Nineteen patients met inclusion criteria. Eleven patients had left lambdoid craniosynostosis, and eight had right lambdoid craniosynostosis. All patients were nonsyndromic. Patients demonstrated contralateral parietal bossing and greater visibility of the ipsilateral ear. Contralateral frontal bossing was mild. The orbits were tall and turricephaly was present in varying severity. Facial scoliosis as a C-shaped deformity was present in varying severity. The nasal root and chin pointed to the contralateral side.
Conclusions:. The combination of greater visibility of the ipsilateral ear, contralateral parietal bossing, and C-shaped convex ipsilateral facial scoliosis are hallmark frontofacial features of unilateral lambdoid craniosynostosis. Although the ipsilateral ear is more posterior, the greater visibility may be attributed to lateral displacement from the mastoid bulge. Evaluation of long-term postoperative results is needed to assess if this pathognomonic facial morphology is corrected following posterior vault reconstruction. |
| first_indexed | 2024-03-13T02:28:28Z |
| format | Article |
| id | doaj.art-ae56b26d2c604057a6debfc194924288 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-13T02:28:28Z |
| publishDate | 2023-05-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-ae56b26d2c604057a6debfc1949242882023-06-30T01:48:43ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-05-01115e501110.1097/GOX.0000000000005011202305000-00019Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter AssessmentJonathan Lee, MD0Sanjay Naran, MD1Daniel Mazzaferro, MD2Ari Wes, MD3Erin E. Anstadt, MD4Jesse Taylor, MD5Jesse Goldstein, MD6Scott Bartlett, MD7Joseph Losee, MD8From the * Division of Plastic and Reconstructive Surgery, Baystate Health System, Springfield, Mass.† Division of Pediatric Plastic Surgery, Advocate Children’s Hospital, Park Ridge, Ill.¶ Division of Plastic and Reconstructive Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa.¶ Division of Plastic and Reconstructive Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa.‡ Division of Pediatric Plastic Surgery, Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pa.¶ Division of Plastic and Reconstructive Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa.‡ Division of Pediatric Plastic Surgery, Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pa.¶ Division of Plastic and Reconstructive Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa.‡ Division of Pediatric Plastic Surgery, Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pa.Background:. Unilateral lambdoid craniosynostosis is differentiated from deformational plagiocephaly primarily by assessing the cranium from posterior and bird’s-eye views. Findings include posterior displacement of the ipsilateral ear, ipsilateral occipitomastoid bossing, ipsilateral occipitoparietal flattening, contralateral parietal bossing, and contralateral frontal bossing. Diagnosis based off facial morphology may be an easier approach because the face is less obstructed by hair and head-coverings, and can easily be assessed when supine. However, frontofacial characteristics of unilateral lambdoid craniosynostosis are not well described. Methods:. A retrospective cohort review of patients with isolated, unilateral lambdoid craniosynostosis from the Children’s Hospital of Pittsburgh and the Children’s Hospital of Philadelphia was performed. Preoperative frontal and profile photographs were reviewed for salient characteristics. Results:. Nineteen patients met inclusion criteria. Eleven patients had left lambdoid craniosynostosis, and eight had right lambdoid craniosynostosis. All patients were nonsyndromic. Patients demonstrated contralateral parietal bossing and greater visibility of the ipsilateral ear. Contralateral frontal bossing was mild. The orbits were tall and turricephaly was present in varying severity. Facial scoliosis as a C-shaped deformity was present in varying severity. The nasal root and chin pointed to the contralateral side. Conclusions:. The combination of greater visibility of the ipsilateral ear, contralateral parietal bossing, and C-shaped convex ipsilateral facial scoliosis are hallmark frontofacial features of unilateral lambdoid craniosynostosis. Although the ipsilateral ear is more posterior, the greater visibility may be attributed to lateral displacement from the mastoid bulge. Evaluation of long-term postoperative results is needed to assess if this pathognomonic facial morphology is corrected following posterior vault reconstruction.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005011 |
| spellingShingle | Jonathan Lee, MD Sanjay Naran, MD Daniel Mazzaferro, MD Ari Wes, MD Erin E. Anstadt, MD Jesse Taylor, MD Jesse Goldstein, MD Scott Bartlett, MD Joseph Losee, MD Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment Plastic and Reconstructive Surgery, Global Open |
| title | Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment |
| title_full | Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment |
| title_fullStr | Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment |
| title_full_unstemmed | Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment |
| title_short | Frontofacial Features of Unilateral Lambdoid Craniosynostosis: A Multicenter Assessment |
| title_sort | frontofacial features of unilateral lambdoid craniosynostosis a multicenter assessment |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005011 |
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