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The significant differences between types 1 and 2 basilar invagination - a case- control study based on the sphenoid

Ítalo T Oliveira Filho1,2, Ricardo V Botelho3,4,5

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Summary

Basilar invagination (BI) involves skull base malformations. Sphenoid bone measurements differentiate BI2 from BI1 and controls, indicating distinct cranial changes in BI2.

Keywords:
Basilar invaginationCephalometricEmbryologyPathophysiologyPlatybasiaSphenoid

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Area of Science:

  • Skull base malformations
  • Craniometry
  • Congenital disorders

Background:

  • Basilar invagination (BI) is a congenital skull base malformation characterized by odontoid process displacement.
  • The sphenoid bone's role in BI pathogenesis is understudied despite its central skull base location.

Purpose of the Study:

  • To compare sphenoid bone craniometric measurements between BI subtypes (BI1, BI2) and healthy controls.
  • To investigate the sphenoid bone's contribution to the distinct phenotypes of basilar invagination.

Main Methods:

  • Cross-sectional study utilizing MRI and CT imaging data from 1985 to 2024.
  • Measurement of sphenoid bone craniometrics in 34 BI1 patients, 38 BI2 patients, and 34 controls.
  • Comparative analysis of horizontal and vertical sphenoid bone dimensions and the sphenoid angle.

Main Results:

  • BI2 patients showed a significantly greater sphenoid crest-clivus distance compared to BI1 and controls.
  • Vertical sphenoid measurements (e.g., basisphenoid length) were significantly shorter in BI2 compared to BI1 and controls.
  • No significant differences were found in the sphenoid angle among the groups, nor between BI1 and controls for other measurements.

Conclusions:

  • Sphenoid bone craniometry effectively distinguishes BI2 from BI1 and controls, highlighting significant cranial base alterations in BI2.
  • BI1 patients exhibit craniometric profiles similar to controls, suggesting their malformation is primarily linked to cranio-cervical segmentation defects rather than extensive sphenoid abnormalities.