midface-hypoplasia-cranial-base-morphology-syndromic-craniosynostosis

Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model

Midface hypoplasia is a common anomaly in children with craniofacial disorders such as cleft palate and syndromic synostosis. A major functional issue ...

Universiti Malaya

Parents play an important role in caring for their children's oral health, especially for those with craniofacial deformities. In this study, we analyzed the oral health knowledge, attitude and practice (KAP) among parents of children of 1 to 16 years-of-age with craniofacial syndromes (CS) at Universiti Malaya Medical Center (UMMC), Malaysia. This was a case-controlled study conducted between March and December 2021 involving 30 parents of children with CS and 30 parents of normal children as controls. A modified validated KAP questionnaire was distributed to all parents. Statistical analysis was carried out using SPSS 26.0 and descriptive analysis was performed, with data expressed as mean, standard deviation, frequency and percentage (%). Most respondents from both groups were mothers (73.3%) between 31 to 40 years-of-age. Both groups of parents had similar levels of oral health knowledge; there was no significant difference between the two groups for 10 of the KAP questions ( > 0.05). However, there was a significant different between the two groups with regards to two 2 relating to the definition of plaque and its relationship to dental caries ( = 0.035 and  = 0.032, respectively). Some parents of CS children believed that primary teeth were not important (23.33%) and were not concerned if their children showed changes in tooth color (26.67%). Despite parental acknowledgement of ideal practice, both groups of children showed irregular dental attendance and reduced toothbrushing frequency. Parents of children with CS had a similar depth of oral health knowledge and a slightly reduced positive attitude when compared to parents in the control group. However, both groups of parents had poor knowledge relating to the transmission and causes of dental caries. Healthcare providers should increase their awareness strategies for parents to be more aware of the ways to improve their children's oral health.

Oral health knowledge, attitude and practice among parents of children with craniofacial syndromes.

ObjectiveTo identify the suitable and practical midsagittal plane (MSP) reference for computed tomography (CT) scan skull analysis in patients with syndromic craniosynostosis.DesignRetrospective study.SettingTertiary referral hospital.Patients and ParticipantsA total of 19 full skull CT scans of syndromic craniosynostosis patients.MethodsSeven craniofacial landmarks located on the midline and 4 MSPs that was previously published and clinically recognized (Planes: SPBaS, SPNSANS, SPLOrPo and SPZFTP) were constructed from the CT images. The absolute distance of every plane from 7 landmarks were then calculated. These distances were subsequently subjected to statistical analysis.Main Outcome Measure(s)The absolute distance of different MSPs from 7 landmarks.ResultsThe distances of landmarks measured to SPBaS were the highest, with the most prominent fluctuation. The fluctuation of the SPNSANS, SPLOrPo and SPZFTP had similar direction changes, with the latter being the closest. Pairwise comparisons demonstrated statistical differences (< .008 using the Bonferroni correction) between the measured distances of A point (M = 0.25, SD = 0.16) and B point (M = 2.21, SD = 1.6) to SPNSANS. There were statistical significances between distances of B point (M = 1.68, SD = 1.07) and CG point (M = 0.55, SD = 0.37) to SPZFTP plane. There was no statistical significance on each landmark to SPLOrPo.ConclusionsThe study demonstrates that SPBaS is not recommended for MSP reference. While SPNSANS should be carefully selected, the application of SPLOrPo and SPZFTP are interchangeable, with the SPZFTP plane slightly exaggerating the mandible deviation relative to the superior and posterior of the midface.

A 3-Dimensional Morphometric Analysis of 4 Midsagittal Planes for CT Scan Reference Determination in Children with Syndromic Craniosynostosis.

Orthognathic surgery in syndromic craniosynostosis: Incorporating midface morphometric analysis and dental parameters in surgical planning.

The craniofacial morphology in patients with syndromic craniosynostosis varies from one spectrum to another. Our study aims to explore the craniofacial morphology and growth pattern in patients with Apert and Crouzon syndrome. This study involved 39 computed tomographic scans of skull (Apert = 11, Crouzon = 10, Control = 18), divided into 2 age subgroups. The non-parametric Mann-Whitney U test was performed to investigate the morphological characteristics between Apert, Crouzon and Control groups. The length of the middle cranial fossa decreased in both syndromes, but clivus length increased slightly in Apert syndrome and decreased in Crouzon syndrome. In Apert syndrome, midface height and width were control, and in Crouzon, the posterior height and width were slightly shorter, and the anterior side was control. The length of the midface was shortened in particular the upper segment. Zygomatic bone length and height as well as zygomatic arch length were developed close to control with a rotation in Apert syndrome. The zygomatic bones and arch in Crouzon syndrome were shortened in length and control in height without a rotation. The contributions of maxillary, zygomatic, and palatal deformities to midface malformation vary between two syndromes. Moreover, there was uneven severity of maxillary and zygomatic developmental deformities in both syndromes.

The cranial base and midface characteristics in apert and Crouzon syndrome: A 3-dimensional analysis of morphological variations.

The restricted intracranial volume in syndromic craniosynostosis is due to limited skull expansion caused by early fusion of multiple cranial sutures. This led to progressive increased in intracranial pressure which has long been established as the cause of optic nerve damage. Optic nerve damage secondary to the narrowing of optic canal in syndromic craniosynostosis has been reported but not comprehensively explored. The objective of this study is to predict using logistic regression the cause of optic nerve atrophy is caused by increased intracranial pressure or structural narrowing of optic canal. The study involved 11 measurements of features of the optic canals as predictor variables. A binary logistic regression and variable selection method were applied to the 11 measurements to choose the best combination of the predictors. The results show good models that could be considered a suitable representation of the data. The height at the optical cranial side is the most dominant feature in the top 20 models that specifies the syndromic patients, followed by the area and the perimeter for both optic canals, then the length of the medial wall and the diameter at the mid canal for right and left canal respectively. The paper's findings provide significant evidence for using this method as an alternative to determine if the cause of optic nerve atrophy is related to either increased intracranial pressure or narrowing optic canal structure among syndromic craniosynostosis patients, thus saving the patient from ineffective operations, additional risks, and waste of resources.

Determining the cause of optic nerve atrophy in syndromic craniosynostosis using logistic regression.

: Patients with syndromic craniosynostosis (SC) pose a significant challenge for post-operational outcomes due to the variability in craniofacial deformities and gain-of-function characteristics. This study aims to develop validated predictive tools using stable cranial base variables to predict changes in the midfacial region and explore the craniofacial morphology among patients with SC. : This study involved 17 SC patients under 12 years old, 17 age-matched controls for morphological analysis, and 21 normal children for developing craniofacial predictive models. A stable cranial base and changeable midfacial variables were analyzed using the Mann-Whitney U test. Pearson correlation identified linear relationships between the midface and cranial base variables. Multicollinearity was checked before fitting the data with multiple linear regression for growth prediction. Model adequacy was confirmed and the 3-fold cross-validation ensured results reliability. : Patients with SC exhibited a shortened cranial base, particularly in the middle cranial fossa (S-SO), and a sharper N-S-SO and N-SO-BA angle, indicating a downward rotation and kyphosis. The midface length (ANS-PNS) and zygomatic length (ZMs-ZTi) were significantly reduced, while the midface width (ZFL-ZFR) was increased. Regression models for the midface length, width, and zygomatic length were given as follows: ANS-PNS = 23.976 + 0.139 S-N + 0.545 SO-BA - 0.120 N-S-BA + 0.078 S-SO-BA + 0.051 age (R = 0.978, RMSE = 1.058); ZFL-ZFR = -15.618 + 0.666 S-N + 0.241 N-S-BA + 0.155 S-SO-BA + 0.121 age (R = 0.903, RMSE = 3.158); and ZMs-ZTi = -14.403 + 0.765 SO-BA + 0.266 N-S-BA + 0.111 age (R = 0.878, RMSE = 3.720), respectively. : The proposed models have potential applications for midfacial growth estimation in children with SC.

Enhancing Predictive Tools for Skeletal Growth and Craniofacial Morphology in Syndromic Craniosynostosis: A Focus on Cranial Base Variables.

Rickettsioses are diseases caused by obligate intracellular non-motile coccobacilli transmitted via arthropods. The most common rickettsioses are scrub typhus (ST), typhus group rickettsioses (TGR), and spotted fever group rickettsioses (SFGR). This study aims to provide information and insight into rickettsioses seropositivity among suspected patients in East and Peninsular Malaysia over a six-year period from 2016 to 2021.

Rickettsioses Seropositivity in Malaysia: A Six-Year Trend, 2016-2021.

The integration of deep learning techniques into sports performance analysis has significantly advanced athlete monitoring, motion tracking, and predictive modelling. These advancements have significantly improved the ability to assess performance, optimize training strategies, and reduce injury risks. However, despite notable progress, challenges remain in standardizing methodologies, ensuring model reliability, and enhancing real-time application across various sports disciplines.

Article	Year
Oral health knowledge, attitude and practice among parents of children with craniofacial syndromes. The Journal of clinical pediatric dentistry\| PubMed ID: 38239169	2024
A 3-Dimensional Morphometric Analysis of 4 Midsagittal Planes for CT Scan Reference Determination in Children with Syndromic Craniosynostosis. The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association\| PubMed ID: 39295317	2025
Orthognathic surgery in syndromic craniosynostosis: Incorporating midface morphometric analysis and dental parameters in surgical planning. Current problems in surgery\| PubMed ID: 39922641	2025
The cranial base and midface characteristics in apert and Crouzon syndrome: A 3-dimensional analysis of morphological variations. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery\| PubMed ID: 40068976	2025
Determining the cause of optic nerve atrophy in syndromic craniosynostosis using logistic regression. International ophthalmology\| PubMed ID: 40159524	2025
Enhancing Predictive Tools for Skeletal Growth and Craniofacial Morphology in Syndromic Craniosynostosis: A Focus on Cranial Base Variables. Diagnostics (Basel, Switzerland)\| PubMed ID: 40647639	2025
Rickettsioses Seropositivity in Malaysia: A Six-Year Trend, 2016-2021. Tropical medicine and infectious disease\| PubMed ID: 40864108	2025
A narrative review of deep learning applications in sports performance analysis: current practices, challenges, and future directions. BMC sports science, medicine & rehabilitation\| PubMed ID: 40866905	2025

Norli Anida Abdullah

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