Nasal Root Deviation in Unicoronal Craniosynostosis: A Craniometric Analysis of Early and Late Postoperative Outcomes
Ari M Wes1, Daniel Mazzaferro, Sanjay Naran
1Division of Plastic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA.
Purpose:
Current operative techniques for correcting unicoronal craniosynostosis (UCS) leave the nasal bones untouched, resulting in an unclear long-term impact on nasal root deviation. The purpose of this study is to quantify nasal root deviation in the preoperative and late postoperative setting in patients who have undergone conventional single-staged UCS correction.
Methods:
The authors performed a retrospective, craniometric analysis of nasal root deviation comparing preoperative computed tomography scans, with those of the early, and late postoperative period. Three vectors were analyzed to measure nasal root deviation, one extending from the nasion to the rhinion (nasal bone vector), the second from the rhinion to the anterior nasal spine (nasal aperture vector), and the third from the nasion to the anterior nasal spine (nasal longitudinal vector).
Results:
Twenty-five subjects were included in the study. Average ages at the time of preoperative, early, and late postoperative imaging were 0.6 ± 0.3, 0.9 ± 0.6, and 9.3 ± 2.7 years, respectively. Improvement of angular deviation of both the nasal aperture vector and nasal longitudinal vector was observed. Mean angular deviation of the nasal aperture vector was 6.0 ± 1.9 degrees preoperatively, 6.0 ± 2.1 degrees early postoperatively (P = 0.952), and 2.4 ± 2.1 in the late postoperative period (P = 0.013). Mean angular deviation of the nasal longitudinal vector was 5.7+2.0 degrees preoperatively, 5.8 ± 2.3 degrees early postoperatively (P = 0.948), and 3.7 ± 1.6 degrees in the late postoperative period (P = 0.019).
Conclusion:
Nasal root deviation decreased significantly only in the late postoperative period, lending credence to the notion that though UCS correction does not directly address nasal root deviation, this pathology improves significantly over time.
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