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Liang C, Marghoub A, Profico A, Buzi C, Didziokas M, van de Lande L, Khonsari RH, Johnson D, O’Higgins P, Moazen M. A physico-mechanical model of postnatal craniofacial growth in human. iScience 2024; 27:110617. [PMID: 39220256 PMCID: PMC11365398 DOI: 10.1016/j.isci.2024.110617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/21/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
Our fundamental understanding of the physico-mechanical forces that drive the size and shape changes of the cranium during ontogeny are limited. Biomechanical models based on finite element method present a huge opportunity to address this critical gap in our knowledge. Here, we describe a validated computational framework to predict normal craniofacial growth. Our results demonstrated that this approach is capable of predicting the growth of calvaria, face, and skull base. We highlighted the crucial role of skull base in antero-posterior growth of the face and also demonstrated the contribution of the maxillary expansion to the dorsoventral growth of the face and its interplay with the orbits. These findings highlight the importance of physical interactions of different components of the craniofacial system. The computational framework described here serves as a powerful tool to study fundamental questions in developmental biology and to advance treatment of conditions affecting the craniofacial system such as craniosynostosis.
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Affiliation(s)
- Ce Liang
- Department of Mechanical Engineering, University College London, London WC1E 7JE, UK
| | - Arsalan Marghoub
- Department of Mechanical Engineering, University College London, London WC1E 7JE, UK
| | - Antonio Profico
- Department of Biology, University of Pisa, 56126 Pisa, Italy
| | - Costantino Buzi
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES-CERCA), 43007 Tarragona, Spain
- Departament d’Història i Història de l’Art, Universitat Rovira i Virgili, 43002 Tarragona, Spain
| | - Marius Didziokas
- Department of Mechanical Engineering, University College London, London WC1E 7JE, UK
| | - Lara van de Lande
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Centre, 3015 GD Rotterdam, the Netherlands
- Craniofacial Growth and Form Laboratory, Hôpital Necker–Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université Paris Cité, 75015 Paris, France
| | - Roman Hossein Khonsari
- Craniofacial Growth and Form Laboratory, Hôpital Necker–Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université Paris Cité, 75015 Paris, France
| | - David Johnson
- Oxford Craniofacial Unit, Oxford University Hospital, Oxford OX3 9DU, UK
| | - Paul O’Higgins
- Department of Archaeology and Hull York Medical School, University of York, York YO10 5DD, UK
| | - Mehran Moazen
- Department of Mechanical Engineering, University College London, London WC1E 7JE, UK
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Ajami S, Van den Dam Z, Hut J, Savery D, Chin M, Koudstaal M, Steacy M, Carriero A, Pitsillides A, Chang YM, Rau C, Marathe S, Dunaway D, Jeelani NUO, Schievano S, Pauws E, Borghi A. Cranial bone microarchitecture in a mouse model for syndromic craniosynostosis. J Anat 2024. [PMID: 39096036 DOI: 10.1111/joa.14121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/27/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
Crouzon syndrome is a congenital craniofacial disorder caused by mutations in the Fibroblast Growth Factor Receptor 2 (FGFR2). It is characterized by the premature fusion of cranial sutures, leading to a brachycephalic head shape, and midfacial hypoplasia. The aim of this study was to investigate the effect of the FGFR2 mutation on the microarchitecture of cranial bones at different stages of postnatal skull development, using the FGFR2C342Y mouse model. Apart from craniosynostosis, this model shows cranial bone abnormalities. High-resolution synchrotron microtomography images of the frontal and parietal bone were acquired for both FGFR2C342Y/+ (Crouzon, heterozygous mutant) and FGFR2+/+ (control, wild-type) mice at five ages (postnatal days 1, 3, 7, 14 and 21, n = 6 each). Morphometric measurements were determined for cortical bone porosity: osteocyte lacunae and canals. General linear model to assess the effect of age, anatomical location and genotype was carried out for each morphometric measurement. Histological analysis was performed to validate the findings. In both groups (Crouzon and wild-type), statistical difference in bone volume fraction, average canal volume, lacunar number density, lacunar volume density and canal volume density was found at most age points, with the frontal bone generally showing higher porosity and fewer lacunae. Frontal bone showed differences between the Crouzon and wild-type groups in terms of lacunar morphometry (average lacunar volume, lacunar number density and lacunar volume density) with larger, less dense lacunae around the postnatal age of P7-P14. Histological analysis of bone showed marked differences in frontal bone only. These findings provide a better understanding of the pathogenesis of Crouzon syndrome and will contribute to computational models that predict postoperative changes with the aim to improve surgical outcome.
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Affiliation(s)
- Sara Ajami
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Craniofacial Unit, Great Ormond Street Hospital, London, UK
| | - Zoe Van den Dam
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Julia Hut
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Dawn Savery
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Milton Chin
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Oral and Maxillofacial Department, Erasmus MC, Rotterdam, The Netherlands
| | - Maarten Koudstaal
- Oral and Maxillofacial Department, Erasmus MC, Rotterdam, The Netherlands
| | - Miranda Steacy
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Alessandra Carriero
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
| | - Andrew Pitsillides
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, UK
| | - Y-M Chang
- Comparative Biomedical Sciences, The Royal Veterinary College, Royal College Street, London, UK
| | - Christoph Rau
- Diamond Light Source, Harwell Science and Innovation Campus, Didcot, UK
| | | | - David Dunaway
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Craniofacial Unit, Great Ormond Street Hospital, London, UK
| | - Noor Ul Owase Jeelani
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Craniofacial Unit, Great Ormond Street Hospital, London, UK
| | - Silvia Schievano
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Craniofacial Unit, Great Ormond Street Hospital, London, UK
| | - Erwin Pauws
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Alessandro Borghi
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Craniofacial Unit, Great Ormond Street Hospital, London, UK
- Department of Engineering, Durham University, Durham, UK
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Liang C, Landi F, Çetin IE, Profico A, Buzi C, Dutel H, Khonsari RH, O'Higgins P, Moazen M. Functional adaptation of the infant craniofacial system to mechanical loadings arising from masticatory forces. Proc Biol Sci 2024; 291:20240654. [PMID: 38889789 DOI: 10.1098/rspb.2024.0654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/18/2024] [Indexed: 06/20/2024] Open
Abstract
The morphology and biomechanics of infant crania undergo significant changes between the pre- and post-weaning phases due to increasing loading of the masticatory system. The aims of this study were to characterize the changes in muscle forces, bite forces and the pattern of mechanical strain and stress arising from the aforementioned forces across crania in the first 48 months of life using imaging and finite element methods. A total of 51 head computed tomography scans of normal individuals were collected and analysed from a larger database of 217 individuals. The estimated mean muscle forces of temporalis, masseter and medial pterygoid increase from 30.9 to 87.0 N, 25.6 to 69.6 N and 23.1 to 58.9 N, respectively (0-48 months). Maximum bite force increases from 90.5 to 184.2 N (3-48 months). There is a change in the pattern of strain and stress from the calvaria to the face during postnatal development. Overall, this study highlights the changes in the mechanics of the craniofacial system during normal development. It further raises questions as to how and what level of changes in the mechanical forces during the development can alter the morphology of the craniofacial system.
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Affiliation(s)
- Ce Liang
- Department of Mechanical Engineering, University College London, London WC1E 7JE, UK
| | - Federica Landi
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES-CERCA), Tarragona 43007, Spain
- Departament d'Història i Història de l'Art, Universitat Rovira i Virgili, Tarragona 43002, Spain
| | - Izel Ezgi Çetin
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Centre, Rotterdam 3015, The Netherlands
- Craniofacial Growth and Form Laboratory, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université Paris Cité, Paris 75015, France
| | - Antonio Profico
- Department of Biology, University of Pisa, Pisa 56126, Italy
| | - Costantino Buzi
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES-CERCA), Tarragona 43007, Spain
- Departament d'Història i Història de l'Art, Universitat Rovira i Virgili, Tarragona 43002, Spain
| | - Hugo Dutel
- Bristol Palaeobiology Group, School of Earth Sciences, University of Bristol, Bristol S8 1TQ, UK
- Université de Bordeaux, CNRS, MCC, PACEA, UMR 5199, Pessac 33600, France
| | - Roman Hossein Khonsari
- Craniofacial Growth and Form Laboratory, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Faculté de Médecine, Université Paris Cité, Paris 75015, France
| | - Paul O'Higgins
- Department of Archaeology and Hull York Medical School, University of York, York YO10 5DD, UK
| | - Mehran Moazen
- Department of Mechanical Engineering, University College London, London WC1E 7JE, UK
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Ng JJ, Massenburg BB, Wu M, Romeo DJ, Swanson JW, Taylor JA, Bartlett SP. Delayed Postnatal Synostosis without Spheno-occipital Synchondrosis Fusion: A Curious Case of Apert Syndrome. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5558. [PMID: 38264445 PMCID: PMC10805437 DOI: 10.1097/gox.0000000000005558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/04/2023] [Indexed: 01/25/2024]
Abstract
Apert syndrome classically presents with craniosynostosis at birth, most commonly of the bilateral coronal sutures, which may lead to cephalocranial disproportion and elevated intracranial pressure, the latter of which is associated with optic atrophy, visual loss, and developmental delays. A small number of patients with syndromic craniosynostosis demonstrate open sutures at birth; however, all previously reported patients of this subtype have been reported to develop premature suture fusion in the early postnatal period and/or require cranial vault expansion for increased intracranial pressure. Here, we report on a patient with Apert syndrome who did not have closed sutures at birth, and only began to demonstrate unilateral coronal suture fusion between ages 4 and 6 years, yet neither developed phenotypic signs of craniosynostosis nor evidence of intracranial hypertension. Moreover, despite demonstrating patency of the spheno-occipital synchondrosis, the patient developed progressive midface hypoplasia, requiring a subcranial Le Fort 3 advancement with external distraction at age 9. Now at skeletal maturity, this patient has a normal cranial shape and will likely never require cranial vault surgery for functional or aesthetic concerns. We are not aware of any prior reports of a patient with Apert syndrome who did not require intracranial surgery over long-term follow-up.
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Affiliation(s)
- Jinggang J. Ng
- From the Division of Plastic, Reconstructive, and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa
| | - Benjamin B. Massenburg
- From the Division of Plastic, Reconstructive, and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa
| | - Meagan Wu
- From the Division of Plastic, Reconstructive, and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa
| | - Dominic J. Romeo
- From the Division of Plastic, Reconstructive, and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa
| | - Jordan W. Swanson
- From the Division of Plastic, Reconstructive, and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa
| | - Jesse A. Taylor
- From the Division of Plastic, Reconstructive, and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa
| | - Scott P. Bartlett
- From the Division of Plastic, Reconstructive, and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pa
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5
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Bordoni B, Escher AR. Rethinking the Origin of the Primary Respiratory Mechanism. Cureus 2023; 15:e46527. [PMID: 37808591 PMCID: PMC10552882 DOI: 10.7759/cureus.46527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 10/10/2023] Open
Abstract
Spheno-occipital synchondrosis (SOS) is the joint regarded as the most important foundation for understanding cranial osteopathy and craniosacral therapy. SOS is the origin of the primary respiratory mechanism (PRM), a movement between the posterior surface of the body of the sphenoid bone and the anterior surface of the base of the occipital bone. From the PRM perspective, an alteration of the position between the two bone surfaces would create cranial and/or craniosacral dysfunction. These positional alterations of the SOS (in adults and children) would determine specific and schematical movements of the bones of the entire skull, whose movements are recognizable by palpation by trained operators. PRM expression is influenced by other elements, such as movement of the cranial bones, inherent movement of the central nervous system, cyclic movement of cerebrospinal fluid (CSF), mechanical tension of the cranial meninges, and passive movement of the sacral bone between the iliac bones. The article reviews the most up-to-date information on the evolution of cranial sutures/joints and meninges in adulthood, the fluctuations of the CSF, brain, and spinal mass movements. Research should reconsider the motivations that induce the operator to discriminate the palpable cranial rhythmic impulse, and probably, to rethink new cranial dysfunctional patterns.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA
| | - Allan R Escher
- Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
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Hodapp M, Hing AV, Gallagher E, Blessing M, Cunningham ML. Isolated frontosphenoidal craniosynostosis: An argument for genetic testing. Am J Med Genet A 2023; 191:2651-2655. [PMID: 37421219 DOI: 10.1002/ajmg.a.63348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023]
Abstract
Isolated frontosphenoidal craniosynostosis (IFSC) is a rare congenital defect defined as premature fusion of the frontosphenoidal suture in the absence of other suture fusion. Until now, IFSC was regarded as a phenomenon with an unclear genetic etiology. We have identified three cases with IFSC with underlying syndromic diagnoses that were attributable to pathogenic mutations involving FGFR3 and MN1, as well as 22q11.2 deletion syndrome. These findings suggest a genetic predisposition to IFSC may exist, thereby justifying the recommendation for genetic evaluation and testing in this population. Furthermore, due to improved imaging resolution, cases of IFSC are now readily identified. With the identification of IFSC with underlying genetic diagnoses, in combination with significant improvements in imaging resolution, we recommend genetic evaluation in children with IFSC.
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Affiliation(s)
- Matthew Hodapp
- University of Nevada, Las Vegas School of Medicine, Las Vegas, Nevada, USA
| | - Anne V Hing
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Emily Gallagher
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Matthew Blessing
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Michael L Cunningham
- Seattle Children's Craniofacial Center, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
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Gorucu-Coskuner H, Al-Yassary M, Billiaert K, Kiliaridis S, Antonarakis GS. Age-related transversal changes in craniofacial sutures of the anterior viscerocranium in growing rats. Front Physiol 2023; 14:1201990. [PMID: 37398902 PMCID: PMC10311509 DOI: 10.3389/fphys.2023.1201990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/08/2023] [Indexed: 07/04/2023] Open
Abstract
Objective: To evaluate the dimensional changes that occur in the internasal and nasopremaxillary sutures, and related transverse craniofacial dimensions, of rats from 4 to 38-weeks of age. Methods: Four groups of twelve male Wistar rats were sacrificed at different ages [4-weeks (immature), 16-weeks (adolescent), 26-weeks (young adult), 38-weeks (adult)]. The rats were scanned with a high-resolution micro-computed tomography imaging device with 90 µm voxel size and 45 mm × 45 mm field of view (FOV) to obtain images of the viscreocranium, and with 10 µm voxel size and 5 mm × 5 mm FOV to obtain images of the internasal and left nasopremaxillary sutures. The nasal bone width, transverse width between the nasopremaxillary sutures and interzygomatic width were measured as craniofacial measurements. The endocranial, ectocranial and mean suture widths (cross-sectional area between endocranial and ectocranial borders/suture height), and suture height were measured at 5 frontal planes with 1.2 mm intervals. Outcomes were compared at different ages, and correlation coefficients were used to assess the relationship between craniofacial and suture changes. Results: All transverse craniofacial dimensions increased significantly from 4-16 weeks of age (p < 0.001). After 16-weeks of age, the only significant increase was observed in interzygomatic width (p = 0.02), between 26 and 38 weeks. In both the internasal and nasopremaxillary sutures, the endocranial suture mean widths decreased from 4-16 weeks (p < 0.001 and p = 0.002, respectively), but did not show any significant change after 16-weeks of age. The ectocranial internasal suture width decreased from 4-16 weeks (p < 0.001), increased until 26-weeks (p = 0.035), and subsequently decreased (p < 0.001). The nasopremaxillary suture widths decreased from 4-38 weeks to varying degrees in different frontal planes. Except for the internasal ectocranial suture width, all suture measurements were found highly and negatively correlated with the transverse craniofacial dimensions. The height of the sutures increased with time, with the most significant changes occurring between 4 and 16 weeks of age (p < 0.001). Conclusion: Although the internasal and nasopremaxillary endocranial suture widths nearly reach their final widths during adolescence, the changes in the ectocranial and mean suture widths continue into early adulthood. These results may serve as a reference for future studies aiming to evaluate the effects of functional demands on suture development and dimensional changes of the viscerocranium.
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Affiliation(s)
- Hande Gorucu-Coskuner
- Department of Orthodontics, Hacettepe University, Ankara, Türkiye
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Mustafa Al-Yassary
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Kelly Billiaert
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Department of Orthodontics, University of Bern, Bern, Switzerland
| | - Gregory S. Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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