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Craniosynostosis incidence with abnormalities of orbital axis on patients under 8 years old
Widiana Ferriastuti1, Suresh Kumar Mukherji2, Syahriar Muhammad1
1Department of Radiology, Dr. Soetomo General and Academic Hospital, Surabaya, East Java, Indonesia.
Insights
Craniosynostosis, a skull growth disorder, is significantly linked to orbital axis (OX) abnormalities. Early CT scan analysis of OX can help prevent strabismus progression in affected children.
Area of Science:
- Pediatric Radiology
- Craniofacial Surgery
- Ophthalmology
Background:
- Craniosynostosis impairs skull growth, potentially causing orbital malformations.
- It affects 1:2000-2500 live births, commonly involving sagittal and coronal sutures.
- Computed tomography (CT) is vital for identifying cranial abnormalities and orbital axis (OX) disruptions.
Purpose of the Study:
- To investigate the correlation between craniosynostosis and orbital axis (OX) abnormalities.
- To assess the utility of CT scans in identifying these abnormalities for early intervention.
Main Methods:
- A case-control study involving pediatric patients (<8 years) with and without craniosynostosis.
- CT images were analyzed to evaluate the position and axis of extraocular muscles.
- Statistical analysis included Chi-square correlation tests.
Main Results:
- A significant correlation was found between craniosynostosis and orbital axis (OX) abnormalities (P-value: 0.000; OR: 22.81).
- The correlation was particularly strong in cases with two or more fused sutures.
Conclusions:
- Craniosynostosis, especially with multiple suture fusions, is significantly associated with orbital axis abnormalities.
- Early CT identification of OX abnormalities in craniosynostosis patients may help prevent strabismus progression.
Background:
Craniosynostosis may result in malformations of the orbit, which can be observed in clinical presentations. Craniosynostosis impairs the normal growth of the skull, which typically occurs perpendicular to the fused suture. Craniosynostosis is classified into non-syndromic and syndromic, with an incidence of 1: 2000-2500 live births. It is commonly affects the sagittal suture (40-60%), followed by the coronal suture (20-30%), the metopic suture (<10%), and rarely the lambdoid suture. Computed tomography (CT) scan plays a crucial role in identifying the type of cranial abnormality and associated disruptions in the orbital axis (OX).
Methods:
The research sample was craniosynostosis patients who were examined at the Radiology Department of Dr. Soetomo General Hospital at Surabaya, Indonesia for the period January 2017-March 2022, male or female aged <8 years and have never had head surgery. Evaluation of the position and axis of the extraocular muscles within the orbits is drawn on the coronal section. In this study, pediatric CT images were acquired at 100 kVp (CTDIvol 2.3 mGy; DLP 84.8 mGy*cm; scan time 6.1 s; helical pitch 0.297). The research was conducted using a case-control method. The case group consisted of patients with craniosynostosis, while the control group included patients without craniosynostosis, encompassing those with conditions such as meningoencephalitis. After the data source is obtained, then the case and control data are matched and then the Chi-square correlation test is carried out through Statistical Package for the Social Sciences.
Results:
A significant correlation was found between the incidence of craniosynostosis and abnormalities of OX (P-value: 0.000; OR: 22.81; R: 0.635).
Conclusion:
There is a significant correlation between the incidence of craniosynostosis that has two or more sutural fusions and abnormalities of OX. Strabismus associated with craniosynostosis is typically detected in patients at an older age. Hopefully, by analyzing the eye angle through CT scans while craniosynostosis is established, abnormalities of the orbital axis can be identified. So the progression of strabismus can be prevented.
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