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Growth of the pediatric skull base: assessment using magnetic resonance imaging
1Department of Pediatric Otolaryngology and Maxillofacial Surgery, Childrens Hospital Medical Center, Cincinnati, OH 45229-2899, USA.
Insights
Skull base development in children shows rapid growth until age 6, slowing thereafter. Males exhibit greater skull base growth than females, aiding surgical planning for pediatric skull base masses.
Area of Science:
- Pediatric Anatomy
- Craniofacial Development
- Radiology
Background:
- Limited data exists on gross anatomical changes during pediatric skull base development.
- Acquiring clinical and autopsy material for skull base growth studies in children is challenging.
Purpose of the Study:
- To evaluate skull base growth in children using normal magnetic resonance imaging (MRI) scans.
- To analyze three-dimensional growth patterns (anterior-posterior, medial-lateral, superior-inferior) of the basicranium.
- To identify potential sex-based differences in skull base growth.
Main Methods:
- Retrospective analysis of normal MRI scans from 76 children aged newborn to 18 years.
- Assessment of basicranium growth in anterior-posterior, medial-lateral, and superior-inferior dimensions.
- Statistical comparison of growth parameters between males and females.
Main Results:
- Skull base growth was rapid until age 6 years, followed by slower growth.
- Males demonstrated significantly greater growth and asymptotic values in the superior-inferior and anterior-posterior dimensions compared to females (P < .05).
Conclusions:
- Understanding pediatric skull base growth patterns is crucial for surgical planning.
- Findings can help surgeons choose operative approaches for pediatric skull base masses, potentially minimizing morbidity.
- Sex-specific growth differences may influence surgical approach selection.
Abstract:
Minimal information is available concerning the gross anatomic changes that occur with skull base development in children. Because clinical and autopsy material to evaluate skull base growth in this population is rare, the author of this study evaluated normal magnetic resonance imaging (MRI) scans in 76 children ranging in age from newborn to 18 years. Growth of the basicranium was assessed in three dimensions: anterior-posterior, medial-lateral, and superior-inferior. In each dimension, growth was noted to be rapid until age 6 years, with relatively slower growth thereafter. In the superior-inferior and anterior-posterior dimensions, both the amount of growth and the asymptotic value were noted to be greater in males than in females (P < .05). The findings of this study can help surgeons select the appropriate operative approach for skull base masses in children. Certain approaches may involve significant morbidity, including mandibulotomy, loss of teeth, oral contamination, and external auditory canal closure. Representative cases managed through an extrapharyngeal transcervical approach are reviewed.
