The morphogenesis of wormian bones: A study of craniosynostosis and purposeful cranial deformation
The morphogenesis of wormian bones: A study of craniosynostosis and purposeful cranial deformation
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DOI：
10.1002/ajmg.a.32073
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发表时间：
2007-12-15
影响因子：
2
通讯作者：
Cunningham, Michael
中科院分区：
文献类型：
--
作者：
Sanchez-Lara, Pedro A.;Graham, John M., Jr.;Cunningham, Michael
蠕虫状骨是发生在颅缝和囟门内的附属骨，最常见于后缝内。它们更常发生在颅骨骨化减少、张力减退或运动减少的疾病中，从而导致变形性短头畸形。蠕虫骨的出现频率和位置随着古代文化中颅骨变形的类型和严重程度而变化。我们认为，蠕虫骨的发病机制可能是由于环境的变化，在开放缝合和<$楼的硬脑膜应变的假设。为了进一步探讨这一点，我们测量了20个故意变形的前哥伦布时期头骨的头指数（CI）：10个来自墨西哥的奇琴伊察，10个来自秘鲁的安孔，以及20个用于医学院解剖课的解剖学上正常的头骨。我们测试了在不同程度的短头畸形的颅骨中，CI和蠕虫骨数量之间的直接相关性，没有发现显著相关性。当CI分为三类（正常（CI < 81.），短头型（CI 81-93）和严重短头型（CI > 93）），随着颅骨变得更短，蠕虫状骨的数量有增加的趋势（P=0.039）。我们的研究的第二部分列出了207例颅缝早闭患者的三维计算机断层扫描（3D-CT）中大蠕虫骨（大于1 cm）的频率和位置，并将这些数据与帕克1905年发表的关于蠕虫骨的手稿中485例正常干燥头骨的数据进行了比较。在颅缝早闭的病例中，大蠕虫骨（207例3D-CT扫描中的117例）比干燥颅骨（485例中的131例）明显更常见。过早缝合导致蠕虫状骨形成的几率高3.5%（P
Wormian bones are accessory bones that Occur within cranial Suture and fontanelles, most commonly within the posterior sutures. They occur more frequently in disorders that have reduced cranial ossification, hypotonia or decreased movement, thereby resulting in deformational brachycephaly. The frequency and location of wormian bones varies with the type and severity of cranial deformation practiced by ancient cultures. We considered the hypothesis that the pathogenesis of wormian bones may be due to environmental variations in dural strain within open sutures and fontanelles. in order to explore this further, we measured the cephalic index (CI) in 20 purposefully deformed pre-Columbian skulls: 10 from Chichen Itza, Mexico, and 10 from Ancon, Peru, as well as 20 anatomically normal skulls used for medical school anatomy classes. We tested for a direct correlation between the CI and the number of wormian bones in skulls with varying degrees of brachycephalic cranial deformation and found no significant correlation. When the CI was grouped into three categories (normal (CI < 81.), brachycephalic (CI 81-93), and severely brachycephalic (CI > 93)) there was a trend toward increasing number of wormian bones as the skull became more brachycephalic (P=0.039). A second part or our study tabulated the frequency and location of large wormian bones (greater than 1 cm) in 3-dimentional computerized tomography (3D-CT) scans from 207 cases of craniosynostosis and compared these data with published data on 485 normal dry skulls from a manuscript on wormian bones by Parker in 1905. Among cases of craniosynostosis, large wormian bones were significantly more frequent (117 out of 207 3D-CT scans) than in dry skulls (131 out of 485). There was a 3.5 greater odds of developing a wormian bone with premature suture closure (P