후방 사두증의 감별진단을 위한 두개 기저부의 역할

The Role of Cranial Base for the Differential Diagnosis of Posterior Plagiocephaly

Posterior plagiocephaly in infants is generally divided into unilateral lambdoid synostosis and deformational plagiocephaly. Because patients with unilateral lambdoid synostosis often undergo surgical therapy unlike deformational plagiocephaly, the differential diagnosis of infants with posterior plagiocephaly is important even though unilateral lambdoid synostosis is significantly rare. The clinical diagnosis commonly used could be subjective, and was inconsistent with computerized tomographic measurements. Because of advance in medical imaging technology, the measurement of cranial base has become a possibility lately. The capacity of anterior and middle cranial fossa areas, posterior fossa deflection angle, and petrous ridge angle could be measured by these observations, patients with unilateral lambdoid synostosis demonstrated the characteristic forms, including deviation of the posterior fossa to the affected side, an enlargement of the contralateral middle cranial fossa, and acute petrous ridge angle on the affected side. And the posterior fossa deflection angle and petrous ridge angle are quantitative measures, which make it possible to compare before and after the surgery and do the follow-up objectively. Therefore comparison by the observation of cranial base is recommended not only as the differential diagnosis of posterior plagiocephaly but also the objective measurement index to estimate the result of the operation and prognosis.