Document Detail

On the origin of bitemporal hollowing.
MedLine Citation:
PMID:  19381101     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Long-term results after cranioplasty for trigonocephaly often show bitemporal hollowing and a residual hypotelorism. Both findings fuel the perception that the growth of the periorbital region and the forehead as a whole continues to be restricted, even after correction. The aim of this study was to evaluate the growth process of the periorbital region after correction for trigonocephaly in the long term. MATERIALS AND METHODS: From 1972 to 2004, 184 patients underwent a cranioplasty for the correction of nonsyndromatic trigonocephaly. Cephalometric analysis was performed in 33 of these patients who had their radiographs taken on the same day as the photograph, at least 1 year postoperative and before the age of 6 years. Cephalic landmarks were used to analyze the growth of the forehead. Because of the lack of standardized cephalograms, growth ratios were used instead of absolute measurements. For visual analysis, normal anteroposterior photographs were used, which were taken on the same day as the radiograph. Two observers evaluated the anteroposterior photographs for the presence and level of temporal hollowing. A score of 0 (normal), 1 (moderate deformity), or 2 (severe deformity) was assigned to each of the photographs. RESULTS: A significant relation was found between a severe deformation seen at postoperative photographic evaluation and a lower growth ratio. The preoperative photo score was not of predicting value for the postoperative growth ratio and therefore, indirectly, for the postoperative photo score. The mean preoperative photo score dropped 5% after surgery. The age at operation had no influence on this postoperative photo score. The experience of the surgeon, however, was a significant contributing factor. CONCLUSIONS: Temporal hollowing seems to be of bony origin and can be explained by skeletal growth inhibition in the affected area. When present immediately after operation, they seem to persist through the years, which makes surgical skill another factor of importance.
Jacques J N M van der Meulen; Joep Willemsen; Joris van der Vlugt; Patricia R N Nazir; Denise Hilling; Irene M J Mathijssen; Edwin Ongkosuwito; Leon N A van Adrichem; Michiel J M Vaandrager; Steven E R Hovius;
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of craniofacial surgery     Volume:  20     ISSN:  1536-3732     ISO Abbreviation:  J Craniofac Surg     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-22     Completed Date:  2009-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010410     Medline TA:  J Craniofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  752-6     Citation Subset:  D    
Department of Plastic and Reconstructive Surgery, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Age Factors
Clinical Competence
Craniosynostoses / surgery*
Follow-Up Studies
Forehead / growth & development,  pathology
Frontal Bone / abnormalities*,  growth & development,  surgery
Image Processing, Computer-Assisted
Muscular Atrophy / etiology
Orbit / growth & development,  pathology,  surgery
Osteotomy / adverse effects,  methods
Postoperative Complications*
Reconstructive Surgical Procedures / adverse effects*,  methods
Retrospective Studies
Sphenoid Bone / growth & development,  pathology
Temporal Bone / pathology*
Temporal Muscle / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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