Three-dimensional spiral CT of craniofacial malformations in children

Objective. To assess the value of three-dimensional CT (3D CT) in the diagn osis and management of suspected paediatric craniofacial malformations. Materials and methods. Twenty-eight children (12 girls, 16 boys) with a mea n age of 4 years, suffering from craniofacial or cervical malformations, un derwent craniofacial spiral CT. 3D reformatting was performed using an inde pendent workstation. Results. 3D CT allowed the preoperative evaluation of 16 patients with cran iosynostosis and the post-surgical management of 2 patients. 3D CT clearly depicted malformations of the skull base involving the petrous bone in seve n patients (four cases of Goldenhar-Gorlin syndrome, one case of Treacher-C ollins syndrome and two cases of Crouton's disease). Four patients with cra niofacial clefts were also evaluated. Radiological findings were confirmed by the clinical and intraoperative findings in all patients that underwent surgical treatment. Movement artefacts and "Lego effect" related to abrupt change of cranial vault border were encountered and are discussed. Conclusions. 3D CT of the skull can safely and reliably identify paediatric craniofacial malformations involving bone, and it should be used as morpho logical mapping to help the surgeon in planning surgical treatment.