1
|
Zucchelli M, Ruggiero F, Babini M, Lefosse M, Borghi A, Rodriguez-Florez N, Tarsitano A, Nicolini F, Galassi E. Surgical strategy in treatment of metopic synostosis in a single centre experience: technical note and quantitative analysis of the outcomes. Childs Nerv Syst 2024:10.1007/s00381-024-06520-7. [PMID: 39001880 DOI: 10.1007/s00381-024-06520-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 06/21/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE Trigonocephaly is the most common craniosynostosis involving orbits. Although some degree of agreement has been reached regarding surgical timing and indications for treatment, there is no consensus regarding the ideal operative technique to guarantee an optimal morphological outcome. The purpose of this study is to describe both strategies and to compare morphological outcomes by means of morphological surface analysis obtained from three-dimensional (3D) stereophotogrammetry, with two different techniques. METHODS We retrospectively investigated 43 patients with metopic synostosis surgically treated between 2004 and 2020. Two different techniques were applied, addressed as technique A and B. Ten patients undergone postoperative 3d stereophotogrammetry were enrolled, and cephalometric measurements were taken and compared to a cohort of unaffected patients matched by age and gender. RESULTS Comparison of the groups demonstrated a hypercorrection of the metopic angle of the second technique, associated with a slightly lower correction of the interfrontoparietal diameter. The metopic angle showed to be significantly undercorrected with the first method. CONCLUSIONS Alternated barrel staving technique appears to be a quick and satisfactory method in cranial remodelling for metopic synostosis. It guarantees an optimal aesthetic result in the first years after surgery.
Collapse
Affiliation(s)
- Mino Zucchelli
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Pediatric Neurosurgery, Bologna, Italy
| | - Federica Ruggiero
- Oral and Maxillofacial Surgery Unit, AUSL Bologna, Bellaria Maggiore Hospital, Bologna, Italy.
- DIBINEM, Alma Mater Studiorum Unversity of Bologna, Bologna, Italy.
| | - Micol Babini
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Pediatric Neurosurgery, Bologna, Italy
| | - Mariella Lefosse
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Pediatric Neurosurgery, Bologna, Italy
| | - Alessandro Borghi
- Department of Engineering, Durham University, Durham, UK
- Great Ormond Street Institute of Child Health, University College of London, London, UK
- Great Ormond Street Hospital for Children, Craniofacial Unit, London, UK
| | - Naiara Rodriguez-Florez
- Universidad de Navarra, TECNUN Escuela de Ingeneiros, San Sebastian, Spain
- Basque Foundation for Science, Bilbao, Spain
| | - Achille Tarsitano
- DIBINEM, Alma Mater Studiorum Unversity of Bologna, Bologna, Italy
- Oral and Maxillofacial Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, 40138, Bologna, Italy
| | - Francesca Nicolini
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Pediatric Neurosurgery, Bologna, Italy
| | - Ercole Galassi
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Pediatric Neurosurgery, Bologna, Italy
| |
Collapse
|
2
|
Kurniawan MS, Tio PA, Abdel Alim T, Roshchupkin G, Dirven CM, Pleumeekers MM, Mathijssen IM, van Veelen MLC. 3D Analysis of the Cranial and Facial Shape in Craniosynostosis Patients: A Systematic Review. J Craniofac Surg 2024; 35:00001665-990000000-01410. [PMID: 38498012 PMCID: PMC11045556 DOI: 10.1097/scs.0000000000010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/29/2024] [Indexed: 03/19/2024] Open
Abstract
With increasing interest in 3D photogrammetry, diverse methods have been developed for craniofacial shape analysis in craniosynostosis patients. This review provides an overview of these methods and offers recommendations for future studies. A systematic literature search was used to identify publications on 3D photogrammetry analyses in craniosynostosis patients until August 2023. Inclusion criteria were original research reporting on 3D photogrammetry analyses in patients with craniosynostosis and written in English. Sixty-three publications that had reproducible methods for measuring cranial, forehead, or facial shape were included in the systematic review. Cranial shape changes were commonly assessed using heat maps and curvature analyses. Publications assessing the forehead utilized volumetric measurements, angles, ratios, and mirroring techniques. Mirroring techniques were frequently used to determine facial asymmetry. Although 3D photogrammetry shows promise, methods vary widely between standardized and less conventional measurements. A standardized protocol for the selection and documentation of landmarks, planes, and measurements across the cranium, forehead, and face is essential for consistent clinical and research applications.
Collapse
Affiliation(s)
| | | | - Tareq Abdel Alim
- Department of Neurosurgery
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center
| | - Gennady Roshchupkin
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center
- Department of Epidemiology, Erasmus MC, University Medical Center
| | | | | | | | - Marie-Lise C. van Veelen
- Department of Neurosurgery
- Child Brain Center, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands
| |
Collapse
|
3
|
Ching JA, Koehl EM, Novak CB, Branson HM, Forrest CR. Nasal monobloc osteotomy for correction of late nasal and orbital asymmetry of unicoronal synostosis: A morphometric and outcomes study. J Plast Reconstr Aesthet Surg 2024; 90:122-129. [PMID: 38367409 DOI: 10.1016/j.bjps.2024.01.018] [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: 11/10/2023] [Revised: 12/21/2023] [Accepted: 01/29/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Craniofacial asymmetry associated with unicoronal synostosis (UCS) may persist into the teenage years despite surgery in infancy. This study evaluated outcomes following a nasal monobloc procedure by mobilizing a united nasomaxillary and bilateral medial orbital segment of bone (nasal monobloc) to perform corrective translational and rotational movement for secondary correction of residual nasal-orbital asymmetry associated with UCS. METHODS A retrospective review of all UCS patients treated with nasal monobloc at our institution was performed. Demographic information was recorded, and pre- and postoperative 2D imaging was used for morphometric outcome analysis. Outcomes and complications were tabulated. RESULTS The study included 14 patients (5 males, 9 females; mean age 14.6 years; range 9.6 to 22.5 years; mean follow-up 70.6 months range 12 to 132 months). Ancillary procedures (scar revision, forehead/orbital contouring, MEDPOR® augmentation) were performed in all patients at the time of the nasal monobloc. One patient underwent a repeat procedure 6 years later following technique modification. Additionally, another patient experienced late overgrowth of the frontal sinus with forehead asymmetry. The morphometric analysis demonstrated significant (p < 0.05) pre-op to post-op improvements in naso-orbital asymmetry, as demonstrated by horizontal orbital aperture ratio (0.88 vs 0.99), midline to exocanthion ratio (0.91 vs 0.98), orbital index ratio (1.15 vs 1.01), and midline discrepancy (7.1 degrees vs 2.7 degrees). CONCLUSION Nasal monobloc osteotomy provides a reasonable surgical treatment to improve both the nasal and orbital asymmetries associated with unicoronal synostosis, including frontal nasal deviation, basal nasal deviation, and orbital aperture asymmetry. It is important to note that confounding anatomic variables such as globe dystopia, strabismus, and scleral show may affect the perception of orbital symmetry.
Collapse
Affiliation(s)
- Jessica A Ching
- Division of Plastic Surgery, University of Florida, Gainesville, FL, USA
| | | | - Christine B Novak
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada
| | - Helen M Branson
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada
| | - Christopher R Forrest
- Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada.
| |
Collapse
|
4
|
Gaillard L. A Suture-specific Photo Score for Metopic Synostosis. J Craniofac Surg 2024; 35:75-79. [PMID: 37815380 PMCID: PMC10749672 DOI: 10.1097/scs.0000000000009773] [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: 04/30/2023] [Accepted: 08/20/2023] [Indexed: 10/11/2023] Open
Abstract
Head shape assessments in children with metopic synostosis are a relevant outcome measure in addition to functional measures, such as neurocognitive outcomes, behavioral outcomes, and visual functioning outcomes. However, consensus on head shape assessments in children with metopic synostosis is lacking. The aim of this study is to develop a reproducible and reliable suture-specific photo score that can be used for cross-center comparison of phenotypical severity of metopic synostosis and evaluation of esthetic outcome of treatment later in childhood. We conducted a retrospective study among nonsyndromic metopic synostosis patients aged <18 years. Preoperative and postoperative photosets of patients with metopic synostosis from 6 expert centers were included. The photo score was discussed in the group of expert craniofacial plastic surgeons and pediatric neurosurgeons. Interrater reliability was determined with modified weighted Fleiss' kappa and intraclass correlation coefficients. Correlation between individual photo score items with overall phenotype was assessed using Spearman correlation analyses. The metopic synostosis photo score contained the following items: "wedging of the forehead", "hypotelorism", "temporal hollowing", "biparietal widening,"and an assessment of "overall phenotype". Items were scored on a 4-point ordinal scale ranging from normal to severe. We found moderate interrater reliability for all items, but substantial agreement for the summed scores. Correlation with overall phenotype was lowest for biparietal widening. To conclude, although agreement on individual photo score items was suboptimal, the agreement on the summed score was substantial, which indicates there is consensus on the overall severity of the metopic synostosis phenotype.
Collapse
|
5
|
Kuehle R, Ringwald F, Bouffleur F, Hagen N, Schaufelberger M, Nahm W, Hoffmann J, Freudlsperger C, Engel M, Eisenmann U. The Use of Artificial Intelligence for the Classification of Craniofacial Deformities. J Clin Med 2023; 12:7082. [PMID: 38002694 PMCID: PMC10672418 DOI: 10.3390/jcm12227082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Positional cranial deformities are a common finding in toddlers, yet differentiation from craniosynostosis can be challenging. The aim of this study was to train convolutional neural networks (CNNs) to classify craniofacial deformities based on 2D images generated using photogrammetry as a radiation-free imaging technique. A total of 487 patients with photogrammetry scans were included in this retrospective cohort study: children with craniosynostosis (n = 227), positional deformities (n = 206), and healthy children (n = 54). Three two-dimensional images were extracted from each photogrammetry scan. The datasets were divided into training, validation, and test sets. During the training, fine-tuned ResNet-152s were utilized. The performance was quantified using tenfold cross-validation. For the detection of craniosynostosis, sensitivity was at 0.94 with a specificity of 0.85. Regarding the differentiation of the five existing classes (trigonocephaly, scaphocephaly, positional plagiocephaly left, positional plagiocephaly right, and healthy), sensitivity ranged from 0.45 (positional plagiocephaly left) to 0.95 (scaphocephaly) and specificity ranged from 0.87 (positional plagiocephaly right) to 0.97 (scaphocephaly). We present a CNN-based approach to classify craniofacial deformities on two-dimensional images with promising results. A larger dataset would be required to identify rarer forms of craniosynostosis as well. The chosen 2D approach enables future applications for digital cameras or smartphones.
Collapse
Affiliation(s)
- Reinald Kuehle
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (F.B.); (J.H.); (C.F.)
| | - Friedemann Ringwald
- Institute of Medical Informatics, University of Heidelberg, 69120 Heidelberg, Germany; (F.R.)
| | - Frederic Bouffleur
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (F.B.); (J.H.); (C.F.)
| | - Niclas Hagen
- Institute of Medical Informatics, University of Heidelberg, 69120 Heidelberg, Germany; (F.R.)
| | - Matthias Schaufelberger
- Institute of Biomedical Engineering, Karlsruhe Institute for Technology, 76131 Karlsruhe, Germany
| | - Werner Nahm
- Institute of Biomedical Engineering, Karlsruhe Institute for Technology, 76131 Karlsruhe, Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (F.B.); (J.H.); (C.F.)
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (F.B.); (J.H.); (C.F.)
| | - Michael Engel
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (F.B.); (J.H.); (C.F.)
| | - Urs Eisenmann
- Institute of Medical Informatics, University of Heidelberg, 69120 Heidelberg, Germany; (F.R.)
| |
Collapse
|
6
|
Trandzhiev M, Vezirska DI, Maslarski I, Milev MD, Laleva L, Nakov V, Cornelius JF, Spiriev T. Photogrammetry Applied to Neurosurgery: A Literature Review. Cureus 2023; 15:e46251. [PMID: 37908958 PMCID: PMC10614469 DOI: 10.7759/cureus.46251] [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] [Accepted: 09/29/2023] [Indexed: 11/02/2023] Open
Abstract
Photogrammetry refers to the process of creating 3D models and taking measurements through the use of photographs. Photogrammetry has many applications in neurosurgery, such as creating 3D anatomical models and diagnosing and evaluating head shape and posture deformities. This review aims to summarize the uses of the technique in the neurosurgical practice and showcase the systems and software required for its implementation. A literature review was done in the online database PubMed. Papers were searched using the keywords "photogrammetry", "neurosurgery", "neuroanatomy", "craniosynostosis" and "scoliosis". The identified articles were later put through primary (abstracts and titles) and secondary (full text) screening for eligibility for inclusion. In total, 86 articles were included in the review from 315 papers identified. The review showed that the main uses of photogrammetry in the field of neurosurgery are related to the creation of 3D models of complex neuroanatomical structures and surgical approaches, accompanied by the uses for diagnosis and evaluation of patients with structural deformities of the head and trunk, such as craniosynostosis and scoliosis. Additionally, three instances of photogrammetry applied for more specific aims, namely, cervical spine surgery, skull-base surgery, and radiosurgery, were identified. Information was extracted on the software and systems used to execute the method. With the development of the photogrammetric method, it has become possible to create accurate 3D models of physical objects and analyze images with dedicated software. In the neurosurgical setting, this has translated into the creation of anatomical teaching models and surgical 3D models as well as the evaluation of head and spine deformities. Through those applications, the method has the potential to facilitate the education of residents and medical students and the diagnosis of patient pathologies.
Collapse
Affiliation(s)
- Martin Trandzhiev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Donika I Vezirska
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Ivan Maslarski
- Department of Anatomy and Histology, Pathology, and Forensic Medicine, University Hospital Lozenetz, Medical Faculty, Sofia University, Sofia, BGR
| | - Milko D Milev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Lili Laleva
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Vladimir Nakov
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| | - Jan F Cornelius
- Department of Neurosurgery, University Hospital of Düsseldorf, Heinrich Heine University, Düsseldorf, DEU
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR
| |
Collapse
|
7
|
Blum JD, Beiriger J, Villavisanis DF, Morales C, Cho DY, Tao W, Whitaker R, Bartlett SP, Taylor JA, Goldstein JA, Swanson JW. Machine Learning in Metopic Craniosynostosis: Does Phenotypic Severity Predict Long-Term Esthetic Outcome? J Craniofac Surg 2023; 34:58-64. [PMID: 35946829 PMCID: PMC9825625 DOI: 10.1097/scs.0000000000008868] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There have been few longitudinal studies assessing the effect of preoperative phenotypic severity on long-term esthetic outcomes in metopic craniosynostosis. This study evaluates the relationship between metopic severity and long-term esthetic outcomes using interfrontal angle (IFA) and CranioRate, a novel metopic synostosis severity measure. METHODS Patients with metopic craniosynostosis who underwent bifrontal orbital advancement and remodeling between 2012 and 2017 were reviewed. Preoperative computed tomography head scans were analyzed for IFA and CranioRate, a machine learning algorithm which generates quantitative severity ratings including metopic severity score (MSS) and cranial morphology deviation (CMD). Long-term esthetic outcomes were assessed by craniofacial surgeons using blinded 3-rater esthetic grading of clinical photos. Raters assessed Whitaker score and the presence of temporal hollowing, lateral orbital retrusion, frontal bone irregularities and/or "any visible irregularities." RESULTS Preoperative scans were performed at a mean age of 7.7±3.4 months, with average MSS of 6/10, CMD of 200/300, and IFA of 116.8±13.8 degrees. Patients underwent bifrontal orbital advancement and remodeling at mean 9.9±3.1 months. The average time from operation to esthetic assessment was 5.4±1.0 years. Pearson correlation revealed a significant negative correlation between MSS and age at computed tomography ( r =-0.451, P =0.004) and IFA ( r =-0.371, P =0.034) and between IFA and age at surgery ( r =-0.383, P =0.018). In multinomial logistic regression, preoperative MSS was the only independent predictor of visible irregularities (odds ratio=2.18, B =0.780, P =0.024) and preoperative IFA alone significantly predicted Whitaker score, with more acute IFA predicting worse Whitaker score (odds ratio=0.928, B =-0.074, P =0.928). CONCLUSIONS More severe preoperative phenotypes of metopic craniosynostosis were associated with worse esthetic dysmorphology. Objective measures of preoperative metopic severity predicted long-term esthetic outcomes.
Collapse
Affiliation(s)
- Jessica D Blum
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia
| | - Justin Beiriger
- Division of Plastic Surgery, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Dillan F Villavisanis
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia
| | - Carrie Morales
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia
| | - Daniel Y Cho
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia
| | - Wenzheng Tao
- School of Computing, University of Utah, Salt Lake City, UT
| | - Ross Whitaker
- School of Computing, University of Utah, Salt Lake City, UT
| | - Scott P Bartlett
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia
| | - Jesse A Taylor
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia
| | - Jesse A Goldstein
- Division of Plastic Surgery, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jordan W Swanson
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia
| |
Collapse
|
8
|
Elawadly A, Smith L, Borghi A, Abdelaziz KI, Silva AHD, Dunaway DJ, Jeelani NUO, Ong J, James G. Correction of trigonocephaly after endoscopic strip craniectomy with postoperative helmet orthosis therapy: a 3D stereophotogrammetric study. J Neurosurg Pediatr 2022; 30:68-77. [PMID: 35364591 DOI: 10.3171/2022.2.peds21546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/07/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Endoscopic strip craniectomy with postoperative helmet orthosis therapy (ESCH) has emerged as a less invasive alternative to fronto-orbital remodeling for correction of trigonocephaly. However, there is no standardized objective method for monitoring morphological changes following ESCH. Such a method should be reproducible and avoid the use of ionizing radiation and general anesthesia for diagnostic imaging. The authors analyzed a number of metrics measured using 3D stereophotogrammetry (3DSPG) following ESCH, an imaging alternative that is free of ionizing radiation and can be performed on awake children. METHODS 3DSPG images obtained at two time points (perisurgical and 1-year follow-up [FU]) of children with metopic synostosis who had undergone ESCH were analyzed and compared to 3DSPG images of age-matched control children without craniofacial anomalies. In total, 9 parameters were measured, the frontal angle and anteroposterior volume in addition to 7 novel parameters: anteroposterior area ratio, anteroposterior width ratios 1 and 2, and right and left anteroposterior diagonal ratios 30 and 60. RESULTS Six eligible patients were identified in the operated group, and 15 children were in the control group. All 9 parameters differed significantly between perisurgical and age-matched controls, as well as from perisurgical to FU scans. Comparison of FU scans of metopic synostosis patients who underwent surgery to scans of age-matched controls without metopic synostosis revealed that all parameters were statistically identical, with the exception of the right anteroposterior diagonal ratio 30, which was not fully corrected in the treated patients. The left anterior part of the head showed the most change in surface area maps. CONCLUSIONS In this pilot study, ESCH showed satisfactory results at 1 year, with improvements in all measured parameters compared to perisurgical results and normalization of 8 of 9 parameters compared to an age-matched control group. The results indicate that these parameters may be useful for craniofacial units for monitoring changes in head shape after ESCH for trigonocephaly and that 3DSPG, which avoids the use of anesthesia and ionizing radiation, is a satisfactory monitoring method.
Collapse
Affiliation(s)
- Ahmed Elawadly
- 1Craniofacial Unit, Great Ormond Street Hospital, London
- 2Great Ormond Street Institute of Child Health, University College London, United Kingdom
- 3Neurosurgery Department, Aswan University, Aswan, Egypt
- 4Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
| | - Luke Smith
- 1Craniofacial Unit, Great Ormond Street Hospital, London
- 2Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - Alessandro Borghi
- 2Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | | | - Adikarige Haritha Dulanka Silva
- 1Craniofacial Unit, Great Ormond Street Hospital, London
- 4Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
| | - David J Dunaway
- 1Craniofacial Unit, Great Ormond Street Hospital, London
- 2Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - Noor Ul Owase Jeelani
- 1Craniofacial Unit, Great Ormond Street Hospital, London
- 2Great Ormond Street Institute of Child Health, University College London, United Kingdom
- 4Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
| | - Juling Ong
- 1Craniofacial Unit, Great Ormond Street Hospital, London
- 2Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | - Greg James
- 1Craniofacial Unit, Great Ormond Street Hospital, London
- 2Great Ormond Street Institute of Child Health, University College London, United Kingdom
- 4Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
| |
Collapse
|
9
|
Potential of Bone-Marrow-Derived Mesenchymal Stem Cells for Maxillofacial and Periodontal Regeneration: A Narrative Review. Int J Dent 2021; 2021:4759492. [PMID: 34795761 PMCID: PMC8594991 DOI: 10.1155/2021/4759492] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/19/2021] [Accepted: 10/25/2021] [Indexed: 12/11/2022] Open
Abstract
Bone-marrow-derived mesenchymal stem cells (BM-MSCs) are one of the most widely studied postnatal stem cell populations and are considered to utilize more frequently in cell-based therapy and cancer. These types of stem cells can undergo multilineage differentiation including blood cells, cardiac cells, and osteogenic cells differentiation, thus providing an alternative source of mesenchymal stem cells (MSCs) for tissue engineering and personalized medicine. Despite the ability to reprogram human adult somatic cells to induced pluripotent stem cells (iPSCs) in culture which provided a great opportunity and opened the new door for establishing the in vitro disease modeling and generating an unlimited source for cell base therapy, using MSCs for regeneration purposes still have a great chance to cure diseases. In this review, we discuss the important issues in MSCs biology including the origin and functions of MSCs and their application for craniofacial and periodontal tissue regeneration, discuss the potential and clinical applications of this type of stem cells in differentiation to maxillofacial bone and cartilage in vitro, and address important future hopes and challenges in this field.
Collapse
|
10
|
Anthropometric cranial measurements in metopic craniosynostosis/trigonocephaly: diagnostic criteria, classification of severity and indications for surgery. J Craniofac Surg 2021; 33:161-167. [PMID: 34690312 DOI: 10.1097/scs.0000000000008196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Metopic craniosynostosis is the second most frequent type of craniosynostosis. When the phenotypic presentation has been deemed severe the treatment is surgical in nature and is performed in infancy with fronto-orbital advancement and cranial vault remodeling. At the time of this writing, there is no consensus regarding an objective evaluation system for severity, diagnostic criteria, or indications for surgery. This study aims to review the anthropometric cranial measurements and the relative diagnostic criteria/classification of severity/surgical indications proposed so far for this skull malformation, and to investigate if there is any scientific support for their utility.
Collapse
|
11
|
Quantifying Orthotic Correction of Trigonocephaly Using Optical Surface Scanning. J Craniofac Surg 2021; 32:1727-1733. [PMID: 34319676 DOI: 10.1097/scs.0000000000007513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Numerous publications describe techniques to measure trigonocephaly caused by metopic synostosis, but they are potentially hazardous for use in acquiring longitudinal data. Optical surface scanning technology can safely yield craniometrics but has not established a practical means for measuring objective morphological changes to trigonocephaly during the practical time constraints of a clinical visit. The purpose of this preliminary study was to evaluate a method for safely and repeatedly measuring frontal angle (FA) using technology available at multiple centers providing treatment with cranial remolding orthoses.Optical scans of infants who underwent endoscopic-assisted minimally-invasive craniectomy for repair of metopic synostosis with cranial remolding were retrospectively analyzed. A novel FA measurement technique "FA30" was developed based on repeatable, geometrically-related surface landmarks approximating the glabella and frontotemporali. Results were compared to a control group and categories of non-synostotic deformity. Inter-rater reliability was assessed for pre- and post-treatment scan measurements among separate clinicians.All trigonocephalic subjects (n = 5) had initial FA30 significantly lower than the control group and other cohorts (P < 0.001). During the course of orthotic cranial remolding following surgical release mean FA30 increased from 121.5° to 138.5° (P < 0.001), approaching the control group mean of 144.4°. Intraclass coefficient calculation showed high reliability (intraclass correlation coefficient: 0.993, 95% confidence interval: 0.957-0.998, P < 0.001), which was supported with Bland-Altman analyses of agreement.Optical surface scanning may provide a safe, accurate, and repeatable means to measure FA. Increase in FA30 demonstrates correction of trigonocephaly. The method presented enables expeditious reporting of treatment progress to the infant's surgeon and parents, and has potential for use in optimizing treatment outcomes at multiple centers.
Collapse
|
12
|
Kuehle R, Ewerbeck N, Rückschloß T, Ristow O, El Damaty A, Freudlsperger C, Hoffmann J, Engel M. Photogrammetric evaluation of corrective surgery for trigonocephaly. Int J Oral Maxillofac Surg 2021; 51:70-77. [PMID: 34229921 DOI: 10.1016/j.ijom.2021.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/30/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study was to capture preoperative, postoperative, and follow-up head shapes of male trigonocephaly patients who underwent fronto-orbital remodelling (FOR), using three-dimensional (3D) photography. Fifty-seven male infants with metopic synostosis operated on using standardized FOR during a 5-year period were included. All measurements were compared with those of an age-matched healthy control cohort (n = 253 for early postoperative comparison, n = 43 for the 1-year follow-up comparison) to determine the effect of FOR at 14 days and at 1 year post-surgery. Intracranial volume, frontal angle, nasofrontal angle, interfrontoparietal-interparietal ratio, and inter-orbital distances were measured 1 day preoperatively, 14 days and 1 year postoperatively. Mean age at surgery was 9.7 ± 1.1 months. Prior to surgery, boys with metopic synostosis showed a reduced intracranial volume (-7.0%, P < 0.001), frontal angle (-10.2%, P < 0.001), interfrontoparietal-interparietal ratio (-4.9%, P < 0.01), and orbital distances (-6.5%, P < 0.001) compared to the reference group, but values did not differ significantly from the specific control group after surgery (all P> 0.05). This was consistent by the time of the follow-up examination. Corrective surgery should therefore aim to achieve volume expansion and correction of the deformity. Furthermore, 3D photogrammetry provides a valuable alternative to computed tomography scans in the diagnosis of metopic synostosis, significantly reducing the amount of radiation exposure to the brain.
Collapse
Affiliation(s)
- R Kuehle
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.
| | - N Ewerbeck
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - T Rückschloß
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - O Ristow
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - A El Damaty
- Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany
| | - C Freudlsperger
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - J Hoffmann
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| | - M Engel
- Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
13
|
Adidharma W, Mercan E, Purnell C, Birgfeld CB, Lee A, Ellenbogen RG, Hopper RA. Evolution of Cranioorbital Shape in Nonsyndromic, Muenke, and Saethre-Chotzen Bilateral Coronal Synostosis: A Case-Control Study of 2-Year Outcomes. Plast Reconstr Surg 2021; 147:148-159. [PMID: 33370058 DOI: 10.1097/prs.0000000000007494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The purpose of this study was to quantify change in cranioorbital morphology from presentation, after fronto-orbital advancement, and at 2-year follow-up. METHODS Volumetric, linear, and angular analyses were performed on computed tomographic scans of consecutive bilateral coronal synostosis patients. Comparisons were made across three time points, between syndromic and nonsyndromic cases, and against normal controls. Significance was set at p < 0.05. RESULTS Twenty-five patients were included: 11 were nonsyndromic, eight had Saethre-Chotzen syndrome, and six had Muenke syndrome. Total cranial volume was comparable to normal, age-matched control subjects before and 2 years after surgery despite an expansion during surgery. Axial and sagittal vector analyses showed advancement and widening of the lower forehead beyond control values with surgery and comparable anterior position, but increased width compared to controls at 2 years. Frontal bossing decreased with a drop in anterior cranial height and advanced lower forehead position. Middle vault height was not normalized and turricephaly persisted at follow-up. Posterior fossa volume remained lower at all three time points compared to control subjects. Supraorbital retrusion relative to anterior corneal position was overcorrected by surgery, with values comparable to those of control subjects at 2 years because of differential growth. There was no difference at 2 years between syndromic and nonsyndromic groups. CONCLUSIONS Open fronto-orbital advancement successfully remodels the anterior forehead but requires overcorrection to be comparable to normal at 2 years. Although there are differences in syndromic cases at presentation, they do not result in significant morphometric differences on follow-up. Posterior fossa volume remains lower at all time points. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
Collapse
Affiliation(s)
- Widya Adidharma
- From the Craniofacial Image Analysis Lab, Craniofacial Center, Seattle Children's Hospital; and the Division of Plastic Surgery and the Department of Neurological Surgery, University of Washington
| | - Ezgi Mercan
- From the Craniofacial Image Analysis Lab, Craniofacial Center, Seattle Children's Hospital; and the Division of Plastic Surgery and the Department of Neurological Surgery, University of Washington
| | - Chad Purnell
- From the Craniofacial Image Analysis Lab, Craniofacial Center, Seattle Children's Hospital; and the Division of Plastic Surgery and the Department of Neurological Surgery, University of Washington
| | - Craig B Birgfeld
- From the Craniofacial Image Analysis Lab, Craniofacial Center, Seattle Children's Hospital; and the Division of Plastic Surgery and the Department of Neurological Surgery, University of Washington
| | - Amy Lee
- From the Craniofacial Image Analysis Lab, Craniofacial Center, Seattle Children's Hospital; and the Division of Plastic Surgery and the Department of Neurological Surgery, University of Washington
| | - Richard G Ellenbogen
- From the Craniofacial Image Analysis Lab, Craniofacial Center, Seattle Children's Hospital; and the Division of Plastic Surgery and the Department of Neurological Surgery, University of Washington
| | - Richard A Hopper
- From the Craniofacial Image Analysis Lab, Craniofacial Center, Seattle Children's Hospital; and the Division of Plastic Surgery and the Department of Neurological Surgery, University of Washington
| |
Collapse
|
14
|
García-Mato D, García-Sevilla M, Porras AR, Ochandiano S, Darriba-Allés JV, García-Leal R, Salmerón JI, Linguraru MG, Pascau J. Three-dimensional photography for intraoperative morphometric analysis in metopic craniosynostosis surgery. Int J Comput Assist Radiol Surg 2021; 16:277-287. [PMID: 33417161 DOI: 10.1007/s11548-020-02301-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Surgical correction of metopic craniosynostosis typically involves open cranial vault remodeling. Accurate translation of the virtual surgical plan into the operating room is challenging due to the lack of tools for intraoperative analysis of the surgical outcome. This study aimed to evaluate the feasibility of using a hand-held 3D photography device for intraoperative evaluation and guidance during cranial vault surgical reconstruction. METHODS A hand-held structured light scanner was used for intraoperative 3D photography during five craniosynostosis surgeries, obtaining 3D models of skin and bone surfaces before and after the remodeling. The accuracy of this device for 3D modeling and morphology quantification was evaluated using preoperative computed tomography imaging as gold-standard. In addition, the time required for intraoperative 3D photograph acquisition was measured. RESULTS The average error of intraoperative 3D photography was 0.30 mm. Moreover, the interfrontal angle and the transverse forehead width were accurately measured in the 3D photographs with an average error of 0.72 degrees and 0.62 mm. Surgeon's feedback indicates that this technology can be integrated into the surgical workflow without substantially increasing surgical time. CONCLUSION Hand-held 3D photography is an accurate technique for objective quantification of intraoperative cranial vault morphology and guidance during metopic craniosynostosis surgical reconstruction. This noninvasive technique does not substantially increase surgical time and does not require exposure to ionizing radiation, presenting a valuable alternative to computed tomography imaging. The proposed methodology can be integrated into the surgical workflow to assist during cranial vault remodeling and ensure optimal surgical outcomes.
Collapse
Affiliation(s)
- David García-Mato
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avenida de la Universidad 30, 28911, Leganés, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Mónica García-Sevilla
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avenida de la Universidad 30, 28911, Leganés, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Antonio R Porras
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA
| | - Santiago Ochandiano
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Juan V Darriba-Allés
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Roberto García-Leal
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José I Salmerón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Marius George Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA
- School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Javier Pascau
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avenida de la Universidad 30, 28911, Leganés, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| |
Collapse
|
15
|
Abdel Alim T, Iping R, Wolvius EB, Mathijssen IMJ, Dirven CMF, Niessen WJ, van Veelen MLC, Roshchupkin GV. Three-Dimensional Stereophotogrammetry in the Evaluation of Craniosynostosis: Current and Potential Use Cases. J Craniofac Surg 2021; 32:956-963. [PMID: 33405445 DOI: 10.1097/scs.0000000000007379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Three-dimensional (3D) stereophotogrammetry is a novel imaging technique that has gained popularity in the medical field as a reliable, non-invasive, and radiation-free imaging modality. It uses optical sensors to acquire multiple 2D images from different angles which are reconstructed into a 3D digital model of the subject's surface. The technique proved to be especially useful in craniofacial applications, where it serves as a tool to overcome the limitations imposed by conventional imaging modalities and subjective evaluation methods. The capability to acquire high-dimensional data in a quick and safe manner and archive them for retrospective longitudinal analyses, provides the field with a methodology to increase the understanding of the morphological development of the cranium, its growth patterns and the effect of different treatments over time.This review describes the role of 3D stereophotogrammetry in the evaluation of craniosynostosis, including reliability studies, current and potential clinical use cases, and practical challenges. Finally, developments within the research field are analyzed by means of bibliometric networks, depicting prominent research topics, authors, and institutions, to stimulate new ideas and collaborations in the field of craniofacial 3D stereophotogrammetry.We anticipate that utilization of this modality's full potential requires a global effort in terms of collaborations, data sharing, standardization, and harmonization. Such developments can facilitate larger studies and novel deep learning methods that can aid in reaching an objective consensus regarding the most effective treatments for patients with craniosynostosis and other craniofacial anomalies, and to increase our understanding of these complex dysmorphologies and associated phenotypes.
Collapse
Affiliation(s)
- Tareq Abdel Alim
- Department of Neurosurgery Department of Radiology and Nuclear Medicine Research Intelligence and Strategy Unit Department of Oral- and Maxillofacial Surgery Department of Plastic, Reconstructive Surgery, and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam Faculty of Applied Sciences, Delft University of Technology, Delft Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Massimi L, Bianchi F, Frassanito P, Calandrelli R, Tamburrini G, Caldarelli M. Imaging in craniosynostosis: when and what? Childs Nerv Syst 2019; 35:2055-2069. [PMID: 31289853 DOI: 10.1007/s00381-019-04278-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Currently, the interest on craniosynostosis in the clinical practice is raised by their increased frequency and their genetic implications other than by the still existing search of less invasive surgical techniques. These reasons, together with the problem of legal issues, make the need of a definite diagnosis for a crucial problem, even in single-suture craniosynostosis (SSC). Although the diagnosis of craniosynostosis is primarily the result of physical examination, craniometrics measuring, and observation of the skull deformity, the radiological assessment currently plays an important role in the confirmation of the diagnosis, the surgical planning, and even the postoperative follow-up. On the other hand, in infants, the use of radiation or the need of sedation/anesthesia raises the problem to reduce them to minimum to preserve such a delicate category of patient from their adverse effects. METHODS, RESULTS AND CONCLUSIONS This review aims at summarizing the state of the art of the role of radiology in craniosynostosis, mainly focusing on indications and techniques, to provide an update not only to pediatric neurosurgeons or maxillofacial surgeons but also to all the other specialists involved in their management, like neonatologists, pediatricians, clinical geneticists, and pediatric neurologists.
Collapse
Affiliation(s)
- L Massimi
- Fondazione Policlinico Gemelli IRCCS, Neurochirurgia Infantile, Rome, Italy.
- Università Cattolica del Sacro Cuore, Istituto Neurochirurgia, Rome, Italy.
| | - F Bianchi
- Fondazione Policlinico Gemelli IRCCS, Neurochirurgia Infantile, Rome, Italy
| | - P Frassanito
- Fondazione Policlinico Gemelli IRCCS, Neurochirurgia Infantile, Rome, Italy
| | - R Calandrelli
- Polo scienze delle immagini, di laboratorio ed infettivologiche, Area diagnostica per immagini, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - G Tamburrini
- Fondazione Policlinico Gemelli IRCCS, Neurochirurgia Infantile, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto Neurochirurgia, Rome, Italy
| | - M Caldarelli
- Fondazione Policlinico Gemelli IRCCS, Neurochirurgia Infantile, Rome, Italy
- Università Cattolica del Sacro Cuore, Istituto Neurochirurgia, Rome, Italy
| |
Collapse
|
17
|
Follow-up study to investigate symmetry and stability of cranioplasty in craniosynostosis – Introduction of new pathology-specific parameters and a comparison to the norm population. J Craniomaxillofac Surg 2019; 47:1441-1448. [DOI: 10.1016/j.jcms.2019.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/17/2019] [Accepted: 07/03/2019] [Indexed: 11/18/2022] Open
|
18
|
Evolution of Bandeau Shape, Orbital Morphology, and Craniofacial Twist after Fronto-Orbital Advancement for Isolated Unilateral Coronal Synostosis. Plast Reconstr Surg 2019; 143:1703-1711. [DOI: 10.1097/prs.0000000000005639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Yang B, Ni J, Li B. 3D morphological change of skull base and fronto-temporal soft-tissue in the patients with unicoronal craniosynostosis after fronto-orbital advancement. Childs Nerv Syst 2018; 34:947-955. [PMID: 29335798 DOI: 10.1007/s00381-018-3721-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 01/03/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aims to comprehensively evaluate the deformation of the skull base and fronto-temporal soft tissue in the patients with anterior plagiocephaly over 1 year of age by three-dimensional (3D) imaging after fronto-orbital advancement (FOA). METHODS We quantitatively analyzed the surgical results and outcome of FOA performed in 10 patients with anterior plagiocephaly. The measurements of the skull base and fronto-temporal soft tissue were performed based on 3D computed tomography (CT) scan. We assessed symmetry of the skull base and fronto-temporal soft tissue change. RESULTS The mean age of patients at FOA was 38.9 months. A significant asymmetry of the skull base was found in all the patients. The growth of the anterior and middle fossae was restricted and the deformation of the fronto-temporal region was marked by soft tissue measurements in different grades. On the follow-up CT images 23.6 months after surgery, there was prominent change (p < 0.05) between the two hemibases (CSO^ ratio) and between the lengths and angles of the anterior and middle cranial hemi-fossae (CX, CSX^, XSM^, XM ratio), especially in grade IIA. Anterior cranial vault asymmetry index obviously decreased to - 1.2 from 12% after surgery (p < 0.05). What's more, ACA^ was also proved to be less after surgical correction (19.91° versus 8.29°, p < 0.01) in grade IIA. The change of fronto-temporal soft tissue was significant such as the frontal angle, the angle of the frontal plane, the fontal-temporal angle, and the angle of the temporal plane in different grades. CONCLUSIONS The asymmetry of the skull base and the deformation of the fronto-temporal region can be presented by intracranial view at over 1 year of age in different grades. FOA can correct the skeletal malformation of the fronto-temporal region as well as soft tissue and the asymmetry of the skull base was improved after surgical treatment.
Collapse
Affiliation(s)
- Bin Yang
- Centre of Maxillofacial Surgery and Digital Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100041, People's Republic of China.
| | - Jian Ni
- Centre of Maxillofacial Surgery and Digital Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100041, People's Republic of China
| | - Binghang Li
- Centre of Maxillofacial Surgery and Digital Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100041, People's Republic of China
| |
Collapse
|
20
|
Simon A, Bocquet E, Pellerin P, Vinchon M, Dhellemmes P, Martinot V, Wolber A, Calibre C, Charlier P, Guerreschi P. Three-dimensional study of 31 cases of synostotic anterior plagiocephaly before and after surgical management the Lille protocol. J Craniomaxillofac Surg 2018; 46:958-966. [PMID: 29661661 DOI: 10.1016/j.jcms.2018.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 02/15/2018] [Accepted: 03/20/2018] [Indexed: 11/28/2022] Open
Abstract
Synostotic anterior plagiocephaly is a rare pathological cranial malformation. Therapeutic options are rarely studied due to the rarity of the malformation and difficulties in diagnosis and care management. The objective of this study was to analyze the results obtained with the Lille protocol based on 62 CT-scans done before and after surgery in 31 patients. A specific analysis was designed for this work. Nine cephalometric measures enabled to evidence on each CT-Scan the corrections made on the fronto-orbital bandeau and the potential impact of surgery on the craniofacial structures. Results show that surgical symmetry of the fronto-orbital bandeau in the transversal plane, according to the symmetrical axis of the semicircular canals, allows a normalization of the skull's growth and morphogenesis for the surgically affected structures but also adjacent ones.
Collapse
Affiliation(s)
- Ambre Simon
- Forensic and Forensic Anthropology Team (UVSQ/EA4569 Paris-Descartes), 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France.
| | | | - Philippe Pellerin
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Matthieu Vinchon
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Patrick Dhellemmes
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Véronique Martinot
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Alexis Wolber
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Clotilde Calibre
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| | - Philippe Charlier
- Forensic and Forensic Anthropology Team (UVSQ/EA4569 Paris-Descartes), 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France; Department of Consultations and Public Health/Health Unit (Hôpital Max Fourestier/Maison d'Arrêt des Hauts-de-Seine), 403 Avenue de la République, 92014, Nanterre, France
| | - Pierre Guerreschi
- CHU Lille, Center for Clefts and Facial Malformations, Plastic Surgery Unit, F-59000, Lille, France
| |
Collapse
|
21
|
Ginat DT, Lam D, Kuhn AS, Reid R. CT Imaging Findings after Craniosynostosis Reconstructive Surgery. Pediatr Neurosurg 2018; 53:215-221. [PMID: 29874675 DOI: 10.1159/000489175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/10/2018] [Indexed: 12/29/2022]
Abstract
Several surgical options are available for treating the different types of craniosynostosis, including fronto-orbital advancement and remodeling, total or subtotal cranial vault remodeling, barrel stave osteotomy with cranial remodeling, endoscopic suturectomy, monobloc advancement and cranioplasty, and revision cranioplasty. High-resolution, low-dose CT with 3D reconstructed images and volumetric analysis can be useful for evaluating the craniofacial skeleton following surgery. The various types of craniosynostosis surgery and corresponding imaging findings are reviewed in this article.
Collapse
Affiliation(s)
| | - Daniel Lam
- Pritzker School of Medicine, Chicago, Illinois, USA
| | - Andrew Scott Kuhn
- Department of Radiology, Yale University, New Haven, Connecticut, USA
| | - Russell Reid
- Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
22
|
Martini M, Klausing A, Messing-Jünger M, Lüchters G. The self-defining axis of symmetry: A new method to determine optimal symmetry and its application and limitation in craniofacial surgery. J Craniomaxillofac Surg 2017; 45:1558-1565. [DOI: 10.1016/j.jcms.2017.06.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/01/2017] [Accepted: 06/27/2017] [Indexed: 11/17/2022] Open
|
23
|
Post-Surgical Relapse in Metopic Synostosis and Limitations of the Interfrontal Angle as an Outcome Measure. J Craniofac Surg 2017; 28:e494-e500. [DOI: 10.1097/scs.0000000000003800] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
24
|
|
25
|
Quantifying the effect of corrective surgery for trigonocephaly: A non-invasive, non-ionizing method using three-dimensional handheld scanning and statistical shape modelling. J Craniomaxillofac Surg 2017; 45:387-394. [DOI: 10.1016/j.jcms.2017.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/30/2016] [Accepted: 01/03/2017] [Indexed: 11/19/2022] Open
|