• Journal of Trauma and Injury
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• v.22 no.1
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• pp.18-23
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• 2009

Purpose: In this study, we retrospectively investigated the medical records of patients with facial fractures and suspected cranial injuries in order to determine if there was any relationship between various facial fracture patterns and cranial injuries. Methods: Medical records were reviewed to identify patients diagnosed with facial fractures who underwent cranial computed tomography (CT) scans. Records were reviewed for gender, age, injury mechanism, facial fracture pattern, and presence or absence of cranial injuries. Facial fracture patterns were classified as isolated fractures (tripod, zygomatic arch, maxilla, orbit, and mandible), combined fractures, or total fractures. Cranial injuries included skull fractures, traumatic subarachnoid hemorrhages, subdural hemorrhages, epidural hemorrhages, and contusional hemorrhages. All cranial injuries were established by using cranial CT scans, and these kinds of cranial injuries were defined radiologically-proven cranial injuries (RPCIs). We evaluated the relationship between each pattern of facial fractures and the incidence of RPCIs. Results: Of 132 eligible patients with facial fractures who underwent cranial CT scans, a total of 27 (20.5%) patients had RPCIs associated with facial fractures. Falls and slips were the most common causes of the fractures (31.8%), followed by assaults and motor vehicle accidents (MVAs). One hundred one (76.5%) patients had isolated facial fractures, and 31 (23.5%) patients had combined facial fractures. Fractures were found most commonly in the orbital and maxillary bones. Patients with isolated maxillary fractures had a lower incidence of RPCIs than those with total mandibular fractures. RPCIs frequently accompanied combined facial fractures. Conclusion: Combined facial fractures had a significant positive correlation with RPCIs. This means that facial fractures caused by stronger or multidirectional external force are likely to be accompanied by cranial injuries.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.229-239
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• 1992

This study was performed to define the adaptation patterns of each skeletal components to the flexures of cranial bases, using 91 males from the ages of 17 to 36 and 64 females from the ages of 16 to 34, without orthodontic or prosthetic treatment experiences and with pleasant profiles as subjects. The conclusions are as follow: 1. When considering the changes of flexure of cranial base (Ba-SE-FMN) in both sexes, changes in the anterior cranial base angle to the PM Vertical line (SE-FMN/PMV) were greater than the changes in the posterior cranial base angle to the PM Vertical line (Ba-SE/PMV). Subsequently the nasomaxillary complex showed antero-superior rotating effect as the cranial base angles were increased and postero-inferior rotating effect as they were decreased. 2. Horizontal mandibular angle (Ba-SE-Me) was increased in both sexes as cranial base angle increases (Ba-SE-FMN) and it decreased as the latter was decreases. There by indicating compensatory effects. 3. Maxillary angle (SE-FMN-A) was decreased in both sexes as cranial base angle (Ba-SE-FMN) increases and it increased as the latter was decreased. There by indicating compensatory effects. 4. Mandibular ramus angle to posterior cranial base was decreased in both sexes as cranial base angle increases. There by indicating compensatory effect to anteriorly displaced maxilla and the mandibular ramus angle was increased as the cranial base angle decreases. There by indicating compensatory effect to posteriorly displace maxilla. 5. The length of posterior upper facial height was decreased in both sexes as the cranial base angle increases and it increased as the latter was decreased.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.744-752
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• 2005

Many craniofacial and neurosurgical procedures rely on cranial bone as a bone graft. In the majority of instances, the bone heals and gives good results. But we found that if either the dura or the pericranium were missing adjacent to the cranial bone, bone absorption would be increased. We studied a single animal model, investigating the contribution of the dura and the pericranium in the process of cranial bone absorption. The animals were divided into four groups of each five animals depending on the differential blockade of the dura and/or the pericranium by silastic sheet. Bilateral $100-mm^2$, parietal bone flaps were harvested from mature rabbits. Animals were humanely killed after 12 weeks, and histomorphometric analysis was performed. The volume maintenance is as follows; Group I; 89.0%, Group II; 80.0%, Group III; 63.3%, Group IV; 52.4%. The weight maintenance; Group I; 87.1%, Group II; 79.4%, Group III; 61.6%, Group IV; 51.1%. The histological contribution of living bone; Group I; 92.9%, Group II; 85.6%, Group III; 71.1%, Group IV; 56.2%. Significantly increased bone absorption occurred in Group II, III, IV compared with Group I. Conclusions are: 1. Cranial bone absorption is effected by both the dura and the pericranium. 2. The dura is more important than the pericranium in preventing cranial bone absorption. 3. The dura to be the source of central cranial bone and the pericranium to be the source of peripheral cranial bone.

• The korean journal of orthodontics
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• v.23 no.4 s.43
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• pp.529-541
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• 1993

The purpose of this study was to investigate not only the variability in the timing and amount of the maximum pubertal spurt in cranial base and mandible, but also its interrelationship with the timing of peak height velocity. This study was carried out by analysing biannual serial lateral cephalometric radiographs of twenty-six males and twenty-one females who were taken from 8.5years to 16.5years old of mean age, according to the established land-marks and linear measurements. The results of this study were summarized as follows. 1. Prevalance of the maximum growth spurt more than 80 percentage was occurred in all measurements of cranial base and mandible, except posterior cranial base length in the female. 2. In all measurements of cranial base and mandible, the maximum spurt was occurred earlier in the female than the male while it was greater in male in all measurements except ramal height. 3. In body height measurement, the peak height velocity was occurred 2 years earlier for the female(11.0 years old) than the male(13.0 years old). 4. The timing of maximum spurt in anterior cranial base length and total mandibular length in both sexes and ramal height in the female were coincided with PHV. The maximum spurt was occurred in both sexes in all measurements 2 years before or after PHV, except mandibular body length and posterior cranial base length the in female. 5. In all ages, there was significant correlation between the total mandibular length and ramal height, and was also correlation between total cranial base length and anterior cranial base length(P<0.05). However, there was no significant correlation between the ramal height and mandibular body length. In addition, there was also no any correlation between the anterior cranial base length and posterior cranial base length in all ages(P>0.05).

• Archives of Craniofacial Surgery
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• v.15 no.2
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• pp.47-52
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• 2014

Background: Management of positional plagiocephaly by wearing a cranial molding helmet has become a matter of growing medical interest. Some research studies reported that starting helmet therapy early (age 5 to 6 months) is important and leads to a significantly better outcome in a shorter treatment time. The aim of the present study was to evaluate the effectiveness of cranial remodeling treatment with wearing helmet for older infants (${\geq}18$ months). Methods: We conducted a retrospective study of 27 infants with positional plagiocephaly without synostosis, who were started from 2008 to 2012. Every child underwent a computerized tomography (CT) before starting helmet therapy to exclude synostosis of the cranial sutures and had CT performed once again after satisfactory completion of therapy. Anthropometric measurements were taken on using spreading calipers in every child. The treatment effect was compared using cranial vault asymmetry (CVA) and the cranial vault asymmetry index (CVAI), which were obtained from diagonal measurements before and after therapy. Results: The discrepancy of CVA and CVAI of all the patients significantly decreased after cranial molding helmet treatment in older infants (${\geq}18$ months) 7.6 mm from 15.6 mm to 8 mm and 4.51% from 9.42% to 4.91%. Six patients had confirmed successful outcome, and all subjects were good compliance patients. The treatment lasted an average of 16.4 months, was well tolerated, and had no complication. Additionally, the rate of the successful treatment (final CVA ${\leq}5mm$) significantly decreased when the wearing time per was shorter. Conclusion: This study showed that treatment by cranial remodeling orthosis was effective if the patient could wear the helmet longer and treatment duration was somewhat longer than in younger patients, well tolerated in older infants and had no morbidity. This therapeutic option is available and indicated in these older infants before other cranial remodeling surgery.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.2
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• pp.117-124
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• 2009

Purpose：The purpose of this study was to investigate of the change of the forward head posture(FHP) according to computer using time. Methods：Subjects were 30 male and 30 female. The factors of FHP were measured cranial vertical angle, cranial rotation angle, and head, upper back, neck flexion/extension angle according to computer using time. Change of FHP used to Digital Inclinometry(JTech, Dualer IQTM Dual Inclinometer). The data were collected by data logger(Logger Teknologi HB, Akarp, Sweden). Results：Cranial vertical angle, cranial rotation angle, and head, upper back, neck flexion/extension were increased according to computer using time(p<.05). But cranial vertical angle and cranial rotation angle, and head, upper back, neck flexion/extension were not significant differences between male and female group(p>.05). Conclusion：The effects of cranial vertical angle, cranial rotation angl and head, neck and upper back angle depend on the computer task time. Increased of FHP may result increased tension in posture muscles of cervical spine, resulting in a risk of musculoskeletal disorders.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.3
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• pp.204-210
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• 2007

This study was intended to compare the cranial base morphology between the mandibular prognathism and maxillary retrognathism in skeletal class III patients. The subject of the present study was composed of 88 patients divided into two groups; Group 1 (Skeletal Class III with mandibular prognathism. SNA within normal range, SNB over normal range, n=54) and Group 2(Skeletal Class III with maxillary retrognathism. SNA below normal range, SNB within normal range, n=34). Lateral cephalogram were taken immediate before surgery and 18 landmarks were used to analyze the characteristics of cranial base and maxillomandibular skeleton. The result revealed that cranial base angle is significantly smaller in Group 1 than Group 2, which implies the influence of the cranial base angulation on the mandibular position. However the posterior cranial base length did not influence the mandibular horizontal position and anterior cranial base length did not influence the maxillary horizontal position. As the anterior cranial base length was closely related with ramal height, it is recommendable to investigate the regulatory mechanism of chondrogenesis of cranial base and condyle cartilage in the future research.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.150-158
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• 2006

Purpose: There are two theories about the relationships between facial fractures and cranial injuries. One is that facial bones act as a protective cushion for the brain, and the other is that facial fractures are the marker for increased risk of cranial injury. They have been debated on for many years. The purpose of this study is to identify the relationship between facial fractures and cranial injuries. Methods: A retrospective study was performed on 242 patients with facial fractures. The data were analyzed based on the medical records of the patients: age, gender, cause of injury, Injury Severity Score (ISS), alcohol intake, type of facial fractures, and type of cranial injury. The patients were divided into two groups: facial fractures with cranial injury and facial fractures without cranial injury. We compared the general characteristics between the two groups and evaluated the relationship between each type of facial fracture and each type of cranial injury. Results: Among the 242 patients with facial bone fractures, 96 (39.7%) patients had a combination of facial fractures and cranial injuries. Gender predilection was demonstrated to favor males: the ratio was 3:1. The mean age was $36.51{\pm}19.63$. As to the injury mechanism, traffic accidents (in car, out of car, motorcycle) were statistically significant in the group of facial fractures with cranial injury (p=0.038, p=0.000, p=0.003). The ISS was significant, but alcohol intake was not significant. No significant relationship between facial fractures and skull fractures was found. Only maxilla fractures, zygoma fractures, and cerebral concussion had a significant difference in cranial injury (p=0.039, p=0.025). Conclusion: There is a no correlation between facial fractures and skull fractures, which suggests that the cushion effect is the predominent relationship between facial fractures and cranial injuries.

• Journal of Korean Neurosurgical Society
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• v.51 no.5
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• pp.305-307
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• 2012

Oblique basal skull fractures resulting from lateral crushing injuries involving both clivus and occipital condyle are rare due to their deep locations. Furthermore, these fractures may present clinically with multiple cranial nerve injuries because neural exit routes are restricted in this intricate region. The authors present an interesting case of basal skull fractures involving the clivus and occipital condyle and presenting with sixth and contralateral twelfth cranial nerve deficits. Clinico-anatomic correlations and the courses of cranial nerve deficits are reiterated. To the authors' knowledge, no other report has been previously issued on concomitant sixth and contralateral twelfth cranial nerve palsies following closed head injury.

• The korean journal of orthodontics
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• v.13 no.1
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• pp.7-14
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• 1983

Serial cephalometric roentgenorgams of 40 Korean children (25 males, 15 females) were employed to study the growth changes of the cranial bases. As a result of this study, the following conclusions can be made: 1. The mean size of the cranial bases in males was larger than the females, especially at the age of 13. 2. In both sexes, growth of the cranial bases was seen from 6 to 13 years of age and the growth of the posterior cranial base (S-Ba) was larger than the anterior cranial base (S-N). 3, Variation in the changes of the saddle angle (Ba-S-N) was exhibited with males showing a marked tendency toward a decrease in saddle angle size.