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Updated: Jun 26, 2026

Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Abnormal basiocciput development in CHARGE syndrome
1Department of Radiology, Endocrinology, Kanagawa Children's Medical Center, Kanagawa, Japan. kazu_kcmc@yahoo.co.jp
Insights
Basioccipital hypoplasia, a rare skull base anomaly, is common in CHARGE syndrome. This condition, often severe, is linked to basilar invagination and Chiari malformation in affected children.
Area of Science:
- Medical Imaging
- Genetics
- Pediatric Radiology
Background:
- CHARGE syndrome is a complex genetic disorder caused by CHD7 mutations.
- Head and neck imaging is crucial for assessing CHARGE syndrome-related abnormalities.
- Basioccipital hypoplasia is a newly identified anomaly in CHARGE syndrome patients.
Purpose of the Study:
- To determine the incidence and severity of basioccipital hypoplasia in CHARGE syndrome.
- To investigate associated anomalies, such as basilar invagination and Chiari malformation.
Main Methods:
- Retrospective review of sagittal MR images from 8 CHARGE syndrome patients.
- Consensual evaluation of basiocciput normality/hypoplasia by two radiologists.
- Measurement of basion-to-sphenoid distances and comparison with 70 age-matched controls.
Main Results:
- Basioccipital hypoplasia was present in 7 of 8 CHARGE syndrome patients, severe in 6.
- Associated anomalies included basilar invagination (5 patients) and Chiari type I malformation with syringomyelia (1 patient).
Conclusions:
- Basioccipital hypoplasia is a prevalent finding in CHARGE syndrome.
- Basilar invagination frequently co-occurs with basioccipital hypoplasia in this population.
Background And Purpose:
The causative gene of the common congenital malformation referred to as CHARGE syndrome is CHD7. Affected individuals often undergo head and neck imaging to assess abnormalities of the olfactory structures, hypothalamus-pituitary axis, and inner ear. We encountered a few children with severe hypoplasia of the basiocciput during a radiologic assessment of patients with CHARGE syndrome. To our knowledge, this anomaly has not been reported. Our purpose was to evaluate the incidence and severity of this anomaly in this syndrome.
Materials And Methods:
Sagittal MR images of 8 patients with CHARGE syndrome were retrospectively reviewed by 2 radiologists who consensually evaluated the status of the basiocciput of the patients with CHARGE syndrome, as either normal or hypoplastic; and associated anomalies, which include basilar invagination, Chiari type I malformation, and syringomyelia, as either present or absent. The length between the basion (Ba) and the endo-sphenobasion (Es) and between the basion and the exo-sphenobasion (Xs) was measured on midsagittal MR images of the 8 patients and 70 age-matched controls. We searched for trends related to age in the length of Ba-Es and Ba-Xs of the control children by using a matched t test.
Results:
Basioccipital hypoplasia was identified in 7 of the 8 patients with CHARGE syndrome and was severe in 6. Of those, 5 had associated basilar invagination and 1 had Chiari type I malformation with syringomyelia.
Conclusions:
Basioccipital hypoplasia and basilar invagination are prevalent in patients with CHARGE syndrome.
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