Combined Transcranial-Microsurgical and Transnasal-Endoscopic “Handshake Approach” – A Contribution to the Management of Intra-Extracranial Anterior Cranial Base Tumors

ABSTRACT Objectives: To test the null hypotheses that the positions of the glenoid fossae and mandibular condyles are identical on the Class I and Class II sides of patients with Class II subdivision malocclusion. Materials and Methods: Retrospective three-dimensional (3D) assessments of the positions of the glenoid fossae and mandibular condyles were made in patients with Class II malocclusion. Relative to a fiducial reference at the anterior cranial base, distances from the glenoid fossae and condyles were calculated in pretreatment cone beam computed tomographic scans of 82 patients: 41 with Class II and 41 with Class II subdivision malocclusions. The 3D distances from glenoid fossae to sella turcica in the X (right-left), Y (anterior-posterior), Z (inferior-superior) projections were calculated. Results: Patients with Class II malocclusion displayed a symmetric position of the glenoid fossae and condyles with no statistically significant differences between sides (P > .05), whereas patients with Class II subdivision showed asymmetry in the distance between the glenoid fossae and anterior cranial base or sella turcica (P < .05), with distally and laterally positioned glenoid fossae on the Class II side. (P < .05). Male patients had greater distances between glenoid fossae and anterior cranial fossae (P < .05). The condylar position relative to the glenoid fossae did not differ between the two malocclusion groups nor between males and females (P > .05). Conclusions: The null hypotheses were rejected. Patients with Class II subdivision malocclusion displayed asymmetrically positioned right- and left-side glenoid fossae, with a distally and laterally positioned Class II side, although the condyles were symmetrically positioned within the glenoid fossae.

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Craniofacial and Craniocervical Features in Cartilage-Hair Hypoplasia: A Radiological Study of 17 Patients and 34 Controls

Frontiers in Endocrinology ◽

10.3389/fendo.2021.741548 ◽

2021 ◽

Vol 12 ◽

Author(s):

Heidi Arponen ◽

Marjut Evälahti ◽

Outi Mäkitie

Keyword(s):

Skull Base ◽

Cranial Base ◽

Basilar Invagination ◽

Craniocervical Junction ◽

Skeletal Class ◽

Base Angle ◽

Cartilage Hair Hypoplasia ◽

Skeletal Class Ii ◽

Anterior Cranial Base ◽

Age Range

BackgroundBiallelic mutations in the non-coding RNA gene RMRP cause Cartilage-hair hypoplasia (CHH), a rare skeletal dysplasia in which the main phenotypic characteristic is severe progressive growth retardation.ObjectiveThis study compared the cranial dimensions of individuals with CHH to healthy subjects.MethodsLateral skull radiographs of 17 patients with CHH (age range 10 to 59 years) and 34 healthy individuals (age range 10 to 54 years) were analyzed for relative position of the jaws to skull base, craniofacial height and depth, as well as vertical growth pattern of the lower jaw, anterior cranial base angle, and the relationship between the cervical spine and skull base.ResultsWe found that the length of the upper and lower jaws, and clivus were significantly decreased in patients with CHH as compared to the controls. Anterior cranial base angle was large in patients with CHH. Basilar invagination was not found.ConclusionThis study found no severe craniofacial involvement of patients with CHH, except for the short jaws. Unexpectedly, mandibular deficiency did not lead to skeletal class II malocclusion.Clinical ImpactAlthough the jaws were shorter in patients with CHH, they were proportional to each other. A short posterior cranial base was not associated with craniocervical junction pathology.

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Reliability of Different Anterior Cranial Base Reference Areas for Voxel-Based Superimposition

Journal of Clinical Medicine ◽

10.3390/jcm10225429 ◽

2021 ◽

Vol 10 (22) ◽

pp. 5429

Author(s):

Mohammed Ghamri ◽

Georgios Kanavakis ◽

Nikolaos Gkantidis

Keyword(s):

Cranial Base ◽

Base Area ◽

Anterior Cranial Base ◽

Base Reference ◽

3D Software ◽

Reference Areas

The study aimed to evaluate the reliability and reproducibility and compare the outcomes of two 3D voxel-based superimposition techniques for craniofacial CBCT images, using anterior cranial base areas of different extent as references. Fifteen preexisting pairs of serial CBCTs (initial age: 11.7 ± 0.6 years; interval: 1.7 ± 0.4 years) were superimposed on total anterior cranial base (TACB) or middle anterior cranial base (MACB) structures through the Dolphin 3D software. The overlap of the reference structures was assessed visually to indicate reliability. All superimpositions were repeated by the same investigator. Outcomes were compared to assess the agreement between the two methods. Reliability was perfect for the TACB and moderate for the MACB method (p = 0.044). Both areas showed good overall reproducibility, though in individual cases there were notable differences for MACB superimpositions, ranging from −1.84 to 1.64 mm (TACB range: −0.48 to 0.31 mm). The overall agreement in the detected T0/T1 changes was also good, though it was significantly reduced for individual measurements (median < 0.01 mm, IQR: 0.46 mm, range: −2.81 to 0.73 mm). In conclusion, the voxel-based superimposition on TACB was more reliable and showed higher reproducibility than the superimposition on MACB. Thus, the extended anterior cranial base area is recommended for the assessment of craniofacial changes.

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