Abstract:
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Purpose: To evaluate C1-C2 vertebral anomalies in children with velopharyngeal insufficiency (VPI) and to define the anomalies present in microdeletion 22q11.2, also known as Velocardiofacial Syndrome (VCFS)
Methods and Materials: 52 sequential patients with velopharyngeal insufficiency (24 M, 28 F) underwent neck CT angiography (CTA) for preoperative evaluation of carotid artery anatomy. 28 patients had proven 22q11.2. The other 24 patients had non-genetic clefting abnormalities resulting in velopharyngeal insufficiency (VPI). Sagittal multiplanar and surface shaded display reformations were obtained retrospectively from the CTA raw data, and were evaluated for the presence of bony craniocervical junction abnormalities
Results: C1 anterior arch midline cleft was observed in 82% (23/28) of patients with VCFS, but in only 4% (1/24) of those with non-genetic VPI. C1 posterior arch cleft was noted in 75% (21/28 VCFS) and 4% (1/24 VPI), respectively. Short C1 posterior arch was noted in 46% (13/28) of patients with VCFS and in 29% (7/24) of patients in the non-genetic VPI group. One VCFS patient had basilar invagination and one VPI patient had occipitalization of C1
Conclusion: C1-C2 vertebral anomalies, in particular C1 midline cleft of the anterior and posterior arches, are usual in VCFS. Since the cervical spine is not routinely imaged in these patients these abnormalities might be underreported. The potential for neurologic compromise while undergoing intubation and positioning for correction operation of velopharyngeal insufficiency will be discussed
Questions about this event email: konen@zahav.net.il
Konen MD, O,
Use of 3D and Multiplanar CT Reformations to Evaluate C1-C2 Vertebral Anomalies in Velopharyngeal Insufficiency Patients with and without Velocardiofacial Syndrome. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3100900.html
