Morphologic Severity of Craniosynostosis: Implications for Speech and Neurodevelopment
Morphologic Severity of Craniosynostosis: Implications for Speech and Neurodevelopment
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颅缝早闭的形态学严重程度：对言语和神经发育的影响
DOI：
10.1177/1055665620984643
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
K. Patel
中科院分区：
文献类型：
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作者：
D. Tandon;G. Skolnick;Sybill Naidoo;L. Grames;M. Cradock;M. Smyth;K. Patel
背景：单缝线颅缝闭锁（SSC）可能与神经发育缺陷有关。我们检查了形态学严重程度与言语语言或心理问题发生率之间的相关性。方法：62例患者（矢状面33例，异位面17例，单冠状面12例），通过术前计算机断层扫描（CT）确定形态学严重程度。矢状面、异位面和单冠状面滑膜闭锁的严重程度指标分别调整头侧指数（aCI）、额间角（IFA）和前颅窝面积比（ACFR）。在≥4.5岁时评估言语语言和心理问题，并将其定义为建议治疗或监测。结果：平均评估年龄为5.7岁；32%的人有语言问题，44%的人有心理问题；44%的人两者都没有。矢状面：有语言问题者的平均aCI（0.62）与无言语问题者的平均aCI（0.62）相等（P = .580），有心理问题者的平均aCI（0.62）与无心理问题者的平均aCI（0.62）相等（P = .572）。Metopic：有（117.9）和没有（125.2）语音语言问题的平均IFA相等（P = .326），有（120.2）和没有（123.2）心理问题的平均IFA相等（P = .711）。单侧：有（0.65）和无（0.69）心理担忧（P = .423）的平均ACFR相等。然而，有（0.74）和没有（0.63）语音语言问题的平均ACFR没有（P = 0.022 *）。双变量秩相关显示，形态学严重程度与言语语言评分之间存在显著相关性（ρ = .722; P = .008*）。结论：相当一部分SSC患者存在言语语言或心理问题。我们没有发现形态严重程度与矢状面或异位性关节闭锁患者的语言或心理问题发生率之间的相关性。形态学严重程度与单冠状关节闭锁患者的语言问题相关。
Background: Single-suture craniosynostosis (SSC) can be associated with neurodevelopmental deficits. We examined the correlation between morphologic severity and incidence of speech-language or psychological concerns. Methods: In 62 patients (33 sagittal, 17 metopic, and 12 unicoronal), morphologic severity was determined via preoperative computed tomography (CT). Severity metrics for sagittal, metopic, and unicoronal synostosis were adjusted cephalic index (aCI), interfrontal angle (IFA), and anterior cranial fossa area ratio (ACFR), respectively. Speech-language and psychological concerns were assessed at age ≥4.5 years and defined as recommendation for therapy or monitoring. Results: Mean assessment age was 5.7 years; 32% had a speech-language concern and 44% had a psychological concern; 44% had neither. Sagittal: Mean aCI of those with a speech-language concern (0.62) and those without (0.62) were equivalent (P = .580), as were mean aCI of those with a psychological concern (0.62) and those without (0.62; P = .572). Metopic: Mean IFA with (117.9) and without (125.2) a speech-language concern were equivalent (P = .326), as were mean IFA with (120.2) and without (123.2) a psychological concern (P = .711). Unicoronal: Mean ACFR with (0.65) and without (0.69) a psychological concern (P = .423) were equivalent. However, mean ACFR with (0.74) and without (0.63) a speech-language concern were not (P = .022*). Bivariate rank correlation showed significant association between morphologic severity and speech-language score only for unicoronal synostosis (ρ = .722; P = .008*). Conclusion: A significant portion of patients with SSC had speech-language or psychological concerns. We found no correlation between morphologic severity and incidence of speech-language or psychological concerns for patients with sagittal or metopic synostosis. Morphological severity did correlate with speech concerns in patients with unicoronal synostosis.