z-logo
open-access-imgOpen Access
Modification of the Fetal Profile Line to Measure Reversal of Forehead Slope after Early Repair of Frontoethmoidal Encephalocele
Author(s) -
Paramita Das,
Martin S. Lacey,
Daniel Guillaume
Publication year - 2020
Publication title -
journal of neurological surgery. part b, skull base
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.488
H-Index - 42
eISSN - 2193-6331
pISSN - 2193-634X
DOI - 10.1055/s-0039-3401998
Subject(s) - forehead , encephalocele , measure (data warehouse) , line (geometry) , geology , medicine , surgery , computer science , mathematics , geometry , database
Objective  Congenital frontoethmoidal encephaloceles are associated with a shallow sloping forehead. We (1) sought to determine if early repair reverses abnormal forehead slope, and (2) assessed a modification of the fetal profile (FP) line to assess results. Design  Study of two cases. Participants  Newborns with frontoethmoidal encephaloceles repaired prior to the age of 4 months with cranial base bone grafting. Main Outcome Measures  Forehead slope was assessed using a modification of the FP line, defined as the line that passes through the anterior border of the mandible and nasion, on pre and postoperative magnetic resonance imaging (MRI) in the midsagittal plane. A modified FP (mFP) line anterior to the forehead was " - ", while a posterior (normal) mFP line was " + ." The largest distance from the mFP line to the forehead was measured. Results  Both infants underwent bifrontal craniotomy, excision of encephalocele, and repair of cribriform plate defect using full-thickness autologous parietal bone before the age of 4 months. Preoperatively, the mFP line was -20.6 mm in case 1, and -9.8 mm in case 2. In both cases, follow-up MRI showed excellent reversal of forehead slope and normal calvarium development. The mFP line improved to +7.4 (age = 16 months) in case 1, and +7.6 (age = 11 months) in case 2. The parietal bone donor site ossified completely within 3 months in both cases. Conclusion  Early repair with bone grafting can promote normal frontal bone development and improve forehead slope. The mFP line is a useful method to measure degree of forehead slope.

The content you want is available to Zendy users.

Already have an account? Click here to sign in.
Having issues? You can contact us here