Skull base growth in craniosynostosis

Although considerable scientific work has been published on the role of the skull base in craniosynostosis, the changes with age throughout childhood have not been fully Outlined. The realisation that little attention has bee n paid to the posterior skull in craniosynostosis, resulted in renewed inte rest in skull base growth. The availability of computer-based image analysi s provides a new accurate method of study in three dimensions. Using three- dimensional visualisation techniques, 34 points of the skull base were iden tified on CT scans of 50 children with craniosynostosis of various types, a ged from 1 month to 5 years. Several distances and angles between the vario us landmarks were measured in an attempt to quantify the growth of skull fo ssae with age. Comparisons were made with normal controls. In children with craniosynostosis, the anterior fossa was over-developed in the males, wher eas in the females remained underdeveloped throughout the first 2 years of life. The body of the sphenoid showed moderate under-development in the fir st 2 years in both sexes, the effect being more:prominent in the males. The middle fossae showed overdevelopment in both sexes in the first 2 years of life. The posterior fossa was underdeveloped in both sexes in the first 2 years of life, the effect being more prominent in the females, Craniosynost osis seems to affect both sexes to a similar degree, but there are regional differences in the growth pattern. Better understanding of the normal grow th pattern of the skull base and the effect of craniosynostosis upon it may assist our approach to surgical treatment and in particular the role of an terior and posterior skull expansive surgery. Copyright (C) 2000 S. Karger AG, Basel.