"Anterior skull base and pericranial flap ossification after frontofacial monobloc advancement".

"Anterior skull base and pericranial flap ossification after frontofacial monobloc advancement".

Plast Reconstr Surg. 2017 Oct 12;:

Authors: Morice A, Paternoster G, Ostertag A, James S, Cohen-Solal M, Khonsari RH, Arnaud E

Abstract
BACKGROUND: Frontofacial monobloc advancement (FFMBA) creates a communication between the anterior cranial fossa and nasal cavities. To tackle this issue, trans-orbital pericranial pedicled flaps (PF) are routinely performed in our center. This study aimed to assess the post-operative ossification of the anterior skull base and PF following FFMBA, and to identify factors influencing this ossification.
METHODS: Measurements of the skull base only (SB) and of the ossified PF together with the SB (SB-OPF) were performed on CT scans at the naso-frontal (NF) and the naso-ethmoïdo-frontal (NEF) junctions. The total thickness of the skull vault was measured and a qualitative defect score for the anterior skull base was computed.
RESULTS: Twenty-two patients who underwent FFMBA at a median age of 3.1 years (1.9 - 3.6) were included: 14 with Crouzon (CS), 5 with Pfeiffer (PS) and 3 with Apert syndrome (AS). One year and five years after surgery, the distraction gap was completely ossified in the anterior skull base midline in all patients. SB-OPF was thicker in patients than in controls at these two time points (p < 0.005 and p < 0.02). Patients with PS had significantly thicker SB and SB-OPF thicknesses (p = 0.01 and p = 0.03) and lower defect scores than patients with CS or AS (p = 0.03) one year post-operatively.
CONCLUSIONS: As ossification of the PF and total re-ossification of the anterior SB midline were observed in all patients, we indicate that performing PF in FFMBA could promote the re-ossification of the anterior skull base.

PMID: 29036029 [PubMed - as supplied by publisher]

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