Objective of this study is to explain all the anatomical damages to occipito-atlo-axial joint and to the cervical spine frequently observed in cranio-mandibular dysmorphisms. These anatomical changes were recently discovered by means of 3D-CT in patients suffering from a lot of mandibulo-facial disorders like laterodeviations, cross bite or hemimandibular elongation. Carefully observing the anatomy of the skull, the authors noticed how in these patients the bony surfaces of the occipito-atlanto-axial joint are displaced so damaging the posture of the upper cervical vertebrae. Looking for an explanation to this clinical finds, on the inferior surface of the skull base they considered the gleno-occipito-mastoid triangle to fully understand the rotatory movements to which the two articular surfaces of this area (mandibular fossa and occipital condyle) are somultaneously subjected at the two sides of the median line. They also studied how the mastoid process in this triangle plays a very important role. A lot of muscles, in fact, attach to its surface and some of these also act very strongly, bringing the head to rotate ventrally toward to the sternum, dorsally toward the cervical spine and down towards the hyoid-mandibular complex. Well thinking to the opposite forces acting in this area, the AA concluded that all the modifications observed on the cervical spine are the effect of the severe unbalance that go on when a laterodeviation of the maxillo-mandibular complex oulls the centre of gravity of the head out of the median line. The spatial displacement of the atlanto-axial joint influences also the direction and the running of the first spinal nerves toward the neck and of the vertebral arteries too when they turn back on the posterior arch of the atlas surrounding the condyles, to join one to the other inside the posterior cranial fossa. All these damages could easily explain the giddness so frequently observed in this patients together with a severe pain to the neck and all the cervical region.

Cervical spine injuries during facial dysmorphisms

CONTINENZA, Maria Adelaide;CUTILLI, Tommaso
1999

Abstract

Objective of this study is to explain all the anatomical damages to occipito-atlo-axial joint and to the cervical spine frequently observed in cranio-mandibular dysmorphisms. These anatomical changes were recently discovered by means of 3D-CT in patients suffering from a lot of mandibulo-facial disorders like laterodeviations, cross bite or hemimandibular elongation. Carefully observing the anatomy of the skull, the authors noticed how in these patients the bony surfaces of the occipito-atlanto-axial joint are displaced so damaging the posture of the upper cervical vertebrae. Looking for an explanation to this clinical finds, on the inferior surface of the skull base they considered the gleno-occipito-mastoid triangle to fully understand the rotatory movements to which the two articular surfaces of this area (mandibular fossa and occipital condyle) are somultaneously subjected at the two sides of the median line. They also studied how the mastoid process in this triangle plays a very important role. A lot of muscles, in fact, attach to its surface and some of these also act very strongly, bringing the head to rotate ventrally toward to the sternum, dorsally toward the cervical spine and down towards the hyoid-mandibular complex. Well thinking to the opposite forces acting in this area, the AA concluded that all the modifications observed on the cervical spine are the effect of the severe unbalance that go on when a laterodeviation of the maxillo-mandibular complex oulls the centre of gravity of the head out of the median line. The spatial displacement of the atlanto-axial joint influences also the direction and the running of the first spinal nerves toward the neck and of the vertebral arteries too when they turn back on the posterior arch of the atlas surrounding the condyles, to join one to the other inside the posterior cranial fossa. All these damages could easily explain the giddness so frequently observed in this patients together with a severe pain to the neck and all the cervical region.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11697/22281
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