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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.authorLU, Xiaona
dc.contributor.authorFORTE, Antonio Jorge
dc.contributor.authorWILSON, Alexander
dc.contributor.authorSTEINBACHER, Derek M.
dc.contributor.authorALPEROVICH, Michael
dc.contributor.authorALONSO, Nivaldo
dc.contributor.authorPERSING, John A.
dc.identifier.citationPLASTIC AND RECONSTRUCTIVE SURGERY, v.145, n.4, p.790E-802E, 2020
dc.description.abstractBackground: Apert syndrome causes normal or enlarged intracranial volume overall as patients grow. This study aimed to trace the segmental anterior, middle, and posterior cranial fossae volume and structural morphology in these patients, to help discern a more focused and individualized surgical treatment plan for patients with Apert syndrome. Methods: This study included 82 preoperative computed tomographic scans (Apert, n = 32; control, n = 50) divided into five age-related subgroups. The scans were measured using image processing and three-dimensional modeling software. Results: The middle cranial fossa volume was increased and was the earliest change noted. It was increased by 45 percent (p = 0.023) compared with controls before 6 months of age and remained increased into adulthood (161 percent, p = 0.016), with gradually increasing severity. The anterior and posterior cranial fossae volumes also increased, by 35 percent (p = 0.032) and 39 percent (p = 0.007), respectively. Increased depth of cranial fossae contributed most to the increase in volumes of patients with Apert syndrome, with correlation coefficients of 0.799, 0.908, and 0.888 for anterior, middle, and posterior cranial fossa, respectively. The intracranial volume was increased 12 percent (p = 0.098) across the entire test age range (0 to 26 years old), but only had statistical significance during the age range of 6 to 18 years (22 percent, p = 0.001). Conclusions: Malformation of the middle cranial fossa is an early, perhaps the initial, pivotal cranial morphologic change in Apert syndrome. Increased cranial fossae depth is an inherent characteristic of the maldevelopment. Normalization of cranial volume and circumference overall may not achieve a normal skull structure, as it does not correct regional craniocerebral disproportion.eng
dc.relation.ispartofPlastic and Reconstructive Surgery
dc.subject.otherintracranial volumeeng
dc.subject.othervault expansioneng
dc.subject.otherskull baseeng
dc.titleCranial Fossa Volume and Morphology Development in Apert Syndromeeng
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINSeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, John A.:hinese Acad Med Sci, Peking Union Med Coll, Plast Surg Hosp, Beijing, Peoples R China
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Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/04
LIM/04 - Laboratório de Microcirurgia

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