Airway Analysis in Apert Syndrome

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFORTE, Antonio J.
dc.contributor.authorLU, Xiaona
dc.contributor.authorHASHIM, Peter W.
dc.contributor.authorSTEINBACHER, Derek M.
dc.contributor.authorALPEROVICH, Michael
dc.contributor.authorPERSING, John A.
dc.contributor.authorALONSO, Nivaldo
dc.date.accessioned2019-11-06T18:45:17Z
dc.date.available2019-11-06T18:45:17Z
dc.date.issued2019
dc.description.abstractBackground: Apert syndrome is frequently combined with respiratory insufficiency, because of the midfacial deformity which, in turn, is influenced by the malformation of the skull base. Respiratory impairment resulting from Apert syndrome is caused by multilevel limitations in airway space. Therefore, this study evaluated the segmented nasopharyngeal and laryngopharyngeal anatomy to clarify subcranial anatomy in children with Apert syndrome and its relevance to clinical management. Methods: Twenty-seven patients (Apert syndrome, n = 10; control, n = 17) were included. All of the computed tomographic scans were obtained from the patients preoperatively, and no patient had confounding disease comorbidity. Computed tomographic scans were analyzed using Surgicase CMF. Craniometric data relating to the midface, airway, and subcranial structures were collected. Statistical significance was determined using t test analysis. Results: Although all of the nasal measurements were consistent with those of the controls, the nasion-to-posterior nasal spine, sphenethmoid-to-posterior nasal spine, sella-to-posterior nasal spine, and basion-to-posterior nasal spine distances were decreased 20 (p < 0.001), 23 (p = 0.001), 29 (p < 0.001), and 22 percent (p < 0.001), respectively. The distance between bilateral gonions and condylions was decreased 17 (p = 0.017) and 18 percent (p = 0.004), respectively. The pharyngeal airway volume was reduced by 40 percent (p = 0.01). Conclusion: The airway compromise seen in patients with Apert syndrome is attributable more to the pharyngeal region than to the nasal cavity, with a gradually worsening trend from the anterior to the posterior airway, resulting in a significantly reduced volume in the hypopharynx.eng
dc.description.indexMEDLINEeng
dc.identifier.citationPLASTIC AND RECONSTRUCTIVE SURGERY, v.144, n.3, p.704-709, 2019
dc.identifier.doi10.1097/PRS.0000000000005937
dc.identifier.eissn1529-4242
dc.identifier.issn0032-1052
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/33909
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINSeng
dc.relation.ispartofPlastic and Reconstructive Surgery
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINSeng
dc.subject.otherobstructive sleep-apneaeng
dc.subject.othercranial baseeng
dc.subject.othermaxillomandibular advancementeng
dc.subject.otherfacial growtheng
dc.subject.otherct-scanseng
dc.subject.othercrouzoneng
dc.subject.othermidfaceeng
dc.subject.othersurgeryeng
dc.subject.othervolumeeng
dc.subject.otherdysmorphologyeng
dc.subject.wosSurgeryeng
dc.titleAirway Analysis in Apert Syndromeeng
dc.typearticleeng
dc.type.categoryeditorial materialeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus15
hcfmusp.contributor.author-fmusphcANTONIO JORGE DE VASCONCELOS FORTE
hcfmusp.contributor.author-fmusphcNIVALDO ALONSO
hcfmusp.description.beginpage704
hcfmusp.description.endpage709
hcfmusp.description.issue3
hcfmusp.description.volume144
hcfmusp.origemWOS
hcfmusp.origem.pubmed31461034
hcfmusp.origem.scopus2-s2.0-85071651055
hcfmusp.origem.wosWOS:000483739400068
hcfmusp.publisher.cityPHILADELPHIAeng
hcfmusp.publisher.countryUSAeng
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