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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.
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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
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Quispe-Enriquez OC, Valero-Lanzuela JJ, Lerma JL. Craniofacial 3D Morphometric Analysis with Smartphone-Based Photogrammetry. SENSORS (BASEL, SWITZERLAND) 2023; 24:230. [PMID: 38203091 PMCID: PMC10781299 DOI: 10.3390/s24010230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
Obtaining 3D craniofacial morphometric data is essential in a variety of medical and educational disciplines. In this study, we explore smartphone-based photogrammetry with photos and video recordings as an effective tool to create accurate and accessible metrics from head 3D models. The research involves the acquisition of craniofacial 3D models on both volunteers and head mannequins using a Samsung Galaxy S22 smartphone. For the photogrammetric processing, Agisoft Metashape v 1.7 and PhotoMeDAS software v 1.7 were used. The Academia 50 white-light scanner was used as reference data (ground truth). A comparison of the obtained 3D meshes was conducted, yielding the following results: 0.22 ± 1.29 mm for photogrammetry with camera photos, 0.47 ± 1.43 mm for videogrammetry with video frames, and 0.39 ± 1.02 mm for PhotoMeDAS. Similarly, anatomical points were measured and linear measurements extracted, yielding the following results: 0.75 mm for photogrammetry, 1 mm for videogrammetry, and 1.25 mm for PhotoMeDAS, despite large differences found in data acquisition and processing time among the four approaches. This study suggests the possibility of integrating photogrammetry either with photos or with video frames and the use of PhotoMeDAS to obtain overall craniofacial 3D models with significant applications in the medical fields of neurosurgery and maxillofacial surgery.
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Affiliation(s)
- Omar C. Quispe-Enriquez
- Photogrammetry and Laser Scanner Research Group (GIFLE), Department of Cartographic Engineering, Geodesy and Photogrammetry, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain; (J.J.V.-L.); (J.L.L.)
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Klieverik VM, Singhal A, Woerdeman PA. Cosmetic satisfaction and patient-reported outcomes following surgical treatment of single-suture craniosynostosis: a systematic review. Childs Nerv Syst 2023; 39:3571-3581. [PMID: 37477663 PMCID: PMC10684623 DOI: 10.1007/s00381-023-06063-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE This study provides a systematic review on cosmetic satisfaction and other patient-reported outcomes (PROMs) of patients who underwent surgical treatment of SSC. METHODS A systematic review of all articles published from inception to 1 June 2022 was performed. Articles were included if they reported on subjective assessment of cosmetic satisfaction or other PROMs by patients or their families using questionnaires or interviews. RESULTS Twelve articles, describing 724 surgical treatments of SSC, met the inclusion criteria. Cosmetic satisfaction was evaluated in the following ways: 1) use of the VAS score, binary questions or a 5-point scale to rate general, facial or skull appearance; 2) use of an aesthetic outcome staging in which personal opinion was added to the treating surgeon's opinion; and 3) use of an evaluation of anatomical proportions of the skull and face. A trend towards an overall improvement in cosmetic satisfaction following surgical treatment of SSC was observed. Reported PROMs included general health, socioeconomic status, patients' and their families' rating of the normalcy and noticeability of their appearance and how much this bothered them, and patients' answers to the Youth Quality of Life with Facial Differences (YQOL-FD) questionnaire. No clear overall trend of the reported PROMs was identified. CONCLUSION This systematic review illuminates that there is a wide variation in outcomes for evaluating cosmetic satisfaction and other PROMs of patients who underwent surgical treatment of SSC, suggesting that further research is needed to develop an inclusive and uniform approach to assess these outcomes.
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Affiliation(s)
- Vita M Klieverik
- Department of Neurology and Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Ash Singhal
- Division of Pediatric Neurosurgery, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Peter A Woerdeman
- Department of Neurology and Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Junn AH, Long AS, Hauc SC, Almeida MN, Alper DP, Rivera JC, Mayes L, Persing JA, Alperovich M. Long-term neurocognitive outcomes in 204 single-suture craniosynostosis patients. Childs Nerv Syst 2023; 39:1921-1928. [PMID: 36877207 DOI: 10.1007/s00381-023-05908-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/25/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE Craniosynostosis, which describes premature fusion of one or more cranial sutures, has been associated with a variety of neurocognitive deficits. We sought to explore the cognitive profiles of the various types of single-suture, non-syndromic craniosynostosis (NSC). METHODS A retrospective review of children 6-18 years old with surgically corrected NSC who underwent neurocognitive testing (Weschler Abbreviated Scale of Intelligence, Beery-Buktenica Developmental Test of Visuomotor Integration) from the years 2014-2022 was conducted. RESULTS 204 patients completed neurocognitive testing (139 sagittal, 39 metopic, 22 unicoronal, 4 lambdoid suture). 110 (54%) of the cohort was male, and 150 (74%) were White. Mean IQ was 106.10±14.01 and mean age at surgery and testing were 9.0±12.2 months and 10.9±4.0 years, respectively. Sagittal synostosis was associated with higher scores than metopic synostosis, with significant differences in verbal IQ (109.42±15.76 vs 101.37±10.41), full-scale IQ (108.32±14.44 vs 100.05±11.76), visuomotor integration (101.62±13.64 vs 92.44±12.07), visual perception (103.81±12.42 vs 95.87±11.23), and motor coordination (90.45±15.60 vs 84.21±15.44). Sagittal synostosis was associated with significantly higher scores for visuomotor integration (101.62±13.64 vs 94.95±10.24) and visual perception (103.81±12.42 vs 94.82±12.75) than unicoronal synostosis. CONCLUSIONS Compared to patients with sagittal synostosis, patients with metopic synostosis exhibited lower scores in verbal IQ, full-scale IQ, visuomotor integration, visual perception, and motor control after surgical correction. Despite surgical correction for premature metopic suture fusion, the effect on the adjacent frontal lobe and white matter connections to other regions of the brain may have a lasting functional impact. Patients with unicoronal synostosis exhibited lower visuomotor integration and visual perception scores.
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Affiliation(s)
- Adam H Junn
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Aaron S Long
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Sacha C Hauc
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Mariana N Almeida
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - David P Alper
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Jean Carlo Rivera
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Linda Mayes
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - John A Persing
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA
| | - Michael Alperovich
- Department of Surgery, Section of Plastic and Reconstructive Surgery, Yale School of Medicine, 330 Cedar Street, Boardman Building, New Haven, CT, 06510, USA.
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Kormi E, Peltola E, Lusila N, Heliövaara A, Leikola J, Suojanen J. Unilateral Cleft Lip and Palate Has Asymmetry of Bony Orbits: A Retrospective Study. J Pers Med 2023; 13:1067. [PMID: 37511680 PMCID: PMC10381611 DOI: 10.3390/jpm13071067] [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: 04/29/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Facial asymmetry is common in unilateral clefts. Since virtual surgical planning (VSP) is becoming more common and automated segmentation is utilized more often, the position and asymmetry of the orbits can affect the design outcome. The aim of this study is to evaluate whether non-syndromic unilateral cleft lip and palate (UCLP) patients requiring orthognathic surgery have asymmetry of the bony orbits. Retrospectively, we analyzed the preoperative cone-beam computed tomography (CBCT) or computed tomography (CT) data of UCLP (n = 15) patients scheduled for a Le Fort 1 (n = 10) or bimaxillary osteotomy (n = 5) with VSP at the Cleft Palate and Craniofacial Center, Helsinki University Hospital. The width, height, and depth of the bony orbit and the distance between the sella turcica and infraorbital canal were measured. A volumetric analysis of the orbits was also performed. The measurements were tested for distribution, and the cleft side and the contralateral side were compared statistically with a two-sided paired t-test. To assess asymmetry in the non-cleft population, we performed the same measurements of skeletal class III patients undergoing orthognathic surgery at Päijät-Häme Central Hospital (n = 16). The volume of bony orbit was statistically significantly smaller (p = 0.014), the distance from the infraorbital canal to sella turcica was shorter (p = 0.019), and the anatomical location of the orbit was more medio-posterior on the cleft side than on the contralateral side. The non-cleft group showed no statistically significant asymmetry in any measurements. According to these preliminary results, UCLP patients undergoing orthognathic surgery show asymmetry of the bony orbit not seen in skeletal class III patients without a cleft. This should be considered in VSP for the correction of maxillary hypoplasia and facial asymmetry in patients with UCLP.
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Affiliation(s)
- Eeva Kormi
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Päijät-Häme Central Hospital, 15850 Lahti, Finland
| | - Elina Peltola
- HUS Diagnostic Center, Radiology, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Niilo Lusila
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Radiology, Päijät-Häme Central Hospital, 15850 Lahti, Finland
| | - Arja Heliövaara
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Junnu Leikola
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland
| | - Juho Suojanen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Päijät-Häme Central Hospital, 15850 Lahti, Finland
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
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Elawadly A, Smith L, Borghi A, Nouby R, Silva AHD, Dunaway DJ, Jeelani NUO, Ong J, James G. 3-Dimensional Morphometric Outcomes After Endoscopic Strip Craniectomy for Unicoronal Synostosis. J Craniofac Surg 2023; 34:322-331. [PMID: 36184769 DOI: 10.1097/scs.0000000000009010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 07/07/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Endoscopic strip craniectomy with postoperative helmeting (ESCH) for unicoronal synostosis has shown to be a less morbid procedure when compared with fronto-orbital remodeling (FOR). We aim in this pilot study to report objective methods and quantitative morphologic outcomes of endoscopically treated unicoronal synostosis using 3-dimensional surface scans. METHODS Our electronic records were reviewed for ophthalmological, neurodevelopmental outcomes, and helmet-related complications. For morphologic outcomes, the following parameters were used: Cranial Index, Cranial Vault Asymmetry Index, Anterior Symmetry Ratio (ASR), and Root Mean Square between the normal and synostotic sides of the head. Three-dimensional stereophotogrammetry scans were evaluated at 3 time points preoperative, 6 months post-op, and at the end of the treatment, which was compared with age-matched scans of normal controls and FOR patients. Nonparametric tests were used for statistical analysis. RESULTS None of the ESCH cases developed strabismus, major neurodevelopmental delay, or helmet complications. All morphologic parameters improved significantly at 6 months post-op except for the Cranial Vault Asymmetry Index. The ASR was the only parameter to change significantly between 6 months post-op and final scans. At end of helmet treatment, ASR and Root Mean Square differed significantly between the ESCH and both FOR and control groups. CONCLUSIONS Endoscopic strip craniectomy with postoperative helmeting for single unicoronal synostosis had excellent clinical outcomes. Most of the improvement in head morphology occurred in the first 6 months of treatment. Despite the normalization of the overall head shape, there was residual asymmetry in the frontal and temporal regions of the head.
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Affiliation(s)
- Ahmed Elawadly
- Craniofacial Unit, Great Ormond Street Hospital
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Neurosurgery Department, Aswan University, Aswan
| | - Luke Smith
- Craniofacial Unit, Great Ormond Street Hospital
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Alessandro Borghi
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Radwan Nouby
- Neurosurgery Department, Assuit University, Assuit, Egypt
| | | | - David J Dunaway
- Craniofacial Unit, Great Ormond Street Hospital
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Noor Ul O Jeelani
- Craniofacial Unit, Great Ormond Street Hospital
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Juling Ong
- Craniofacial Unit, Great Ormond Street Hospital
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Greg James
- Craniofacial Unit, Great Ormond Street Hospital
- Great Ormond Street Institute of Child Health, University College London, London, UK
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Svalina A, Heikura E, Savolainen T, Serlo W, Sinikumpu JJ, Silvola AS, Salokorpi N. Appearance or attitude: what matters to craniosynostosis patients? Association of self-esteem, depressive symptoms, and facial aesthetics in patients with sagittal and metopic synostosis. Childs Nerv Syst 2022; 38:1929-1936. [PMID: 35732900 PMCID: PMC9522694 DOI: 10.1007/s00381-022-05587-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE The aim of this study was to investigate the presence of depressive symptoms and self-esteem, and their association with facial asymmetry in adults who were operated on in early childhood due to metopic and sagittal craniosynostosis. METHODS The study population consisted of 49 non-syndromic patients of whom 41 had premature fusion of the sagittal and 8 of metopic suture. There were 64 controls from the Finnish National Register. Self-esteem, depressive symptoms, and subjective satisfaction with one's appearance were evaluated by using the Rosenberg self-esteem questionnaire (RSE), the short form of Beck Depression Inventory (R-BDI), and a purpose-designed questionnaire on satisfaction with facial and overall appearance. Aesthetic evaluation was done from standard photographs using panels. The facial symmetry was calculated by using 3D photogrammetric methods. RESULTS Patients did not have a lower self-esteem or experience significantly more moderate or severe depressive symptoms. However, 20% of the patients and 6% of the controls (p = 0.041) experienced mild depressive symptoms. There was no difference between self-assessed evaluation of appearance between the groups. Only weak correlation was found between facial asymmetry and RSE or R-BDI results (cc = 0.27-0.42, p < 0.05). The self-assessed evaluation of facial and overall appearance correlated strongly with the R-BDI results. CONCLUSION Non-syndromic craniosynostosis patients are as satisfied with their appearance in adulthood as the control group and do not experience a lower self-esteem or more depressive symptoms. Facial asymmetry does not correlate with low self-esteem or clinically significant depressive symptoms in adulthood. Subjective evaluation of one's appearance correlated with depressive symptoms. Age and gender do not influence the former results. Overall, patients are satisfied with their appearance.
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Affiliation(s)
- Anja Svalina
- Research Unit of Clinical Neuroscience, Oulu University Hospital and University of Oulu, Oulu, Finland. .,PEDEGO Research Group, University of Oulu, Oulu, Finland. .,Department of Neurosurgery, Oulu University Hospital, PO Box 21, 90029, Oulu, OYS, Finland.
| | - Emma Heikura
- grid.10858.340000 0001 0941 4873PEDEGO Research Group, University of Oulu, Oulu, Finland
| | - Tuula Savolainen
- grid.412326.00000 0004 4685 4917Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Willy Serlo
- grid.10858.340000 0001 0941 4873PEDEGO Research Group, University of Oulu, Oulu, Finland ,grid.412326.00000 0004 4685 4917Medical Research Center, Oulu University Hospital, Oulu, Finland ,grid.412326.00000 0004 4685 4917Department of Children and Adolescent, Oulu University Hospital, Oulu, Finland
| | - Juha-Jaakko Sinikumpu
- grid.10858.340000 0001 0941 4873PEDEGO Research Group, University of Oulu, Oulu, Finland ,grid.412326.00000 0004 4685 4917Medical Research Center, Oulu University Hospital, Oulu, Finland ,grid.412326.00000 0004 4685 4917Department of Children and Adolescent, Oulu University Hospital, Oulu, Finland
| | - Anna-Sofia Silvola
- grid.412326.00000 0004 4685 4917Medical Research Center, Oulu University Hospital, Oulu, Finland ,grid.10858.340000 0001 0941 4873Department of Orthodontics, Faculty of Medicine, Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Niina Salokorpi
- grid.412326.00000 0004 4685 4917Research Unit of Clinical Neuroscience, Oulu University Hospital and University of Oulu, Oulu, Finland ,grid.412326.00000 0004 4685 4917Medical Research Center, Oulu University Hospital, Oulu, Finland
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Svalina A, Vuollo V, Serlo W, Sinikumpu JJ, Silvola AS, Salokorpi N. Craniofacial characteristics and cosmetic satisfaction of patients with sagittal and metopic synostosis: a case-control study using 3D photogrammetric imaging. Childs Nerv Syst 2022; 38:781-788. [PMID: 34940889 PMCID: PMC8940850 DOI: 10.1007/s00381-021-05434-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to investigate the craniofacial and aesthetic characteristics of adult metopic and sagittal craniosynostosis patients operated on in early childhood compared to controls. The goal was to find objective measurements that would correlate with the patient's subjective self-evaluation of their own cosmetic appearance. METHODS The study population consisted of 49 patients from whom 41 had premature fusion of the sagittal and in 8 of metopic suture. There were 65 age and gender matching controls from The Finish National Register. The 3D photogrammetric models were created from all patients and controls. The images were analysed using Rapidform 2006. Facial landmarks were set by the standard Farkas points. Facial symmetry parameters were calculated by using the landmarks and the mirror shell of the face. Aesthetic evaluation was done from standard photographs using panels. Subjective satisfaction with one's own appearance was evaluated using questionnaires. RESULTS Patients had the greatest asymmetry in the forehead area when compared to controls (symmetry percentage 59% versus 66%, p = 0.013). In the control group, the gap between the eyes was smaller than in the case group, resulting in an absolute 2 mm difference (p = 0.003). The area of the chin and the landmarks were more located on the left side in the patient group, resulting in up to a 1.1 mm difference between the groups (p = 0.003). Only a weak association was found between craniofacial symmetry and appearance evaluations. CONCLUSION Patients operated on because of sagittal and metopic synostoses were found to have facial asymmetry at long follow-up. However, the differences were < 3 mm and not clinically important. The long-term aesthetical outcome of the surgery performed because of sagittal or metopic craniosynostosis based on the 3D image evaluation was good.
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Affiliation(s)
- Anja Svalina
- Department of Neurosurgery, Oulu University Hospital, Oulu, Finland. .,Medical Research Center, Oulu University Hospital, Oulu, Finland.
| | - Ville Vuollo
- Medical Research Center, Oulu University Hospital, Oulu, Finland ,Faculty of Medicine, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Willy Serlo
- Medical Research Center, Oulu University Hospital, Oulu, Finland ,Department of Children and Adolescent, Oulu University Hospital, Oulu, Finland ,PEDEGO Research Group, University of Oulu, Oulu, Finland
| | - Juha-Jaakko Sinikumpu
- Medical Research Center, Oulu University Hospital, Oulu, Finland ,Department of Children and Adolescent, Oulu University Hospital, Oulu, Finland ,PEDEGO Research Group, University of Oulu, Oulu, Finland
| | - Anna-Sofia Silvola
- Medical Research Center, Oulu University Hospital, Oulu, Finland ,Department of Orthodontics, Faculty of Medicine, Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Niina Salokorpi
- Department of Neurosurgery, Oulu University Hospital, Oulu, Finland ,Medical Research Center, Oulu University Hospital, Oulu, Finland ,Research Unit of Clinical Neuroscience, Oulu University Hospital and University of Oulu, Oulu, Finland
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Virtual Coordinate System in Unicoronal Synostosis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3616. [PMID: 34422508 PMCID: PMC8376362 DOI: 10.1097/gox.0000000000003616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/26/2021] [Indexed: 11/26/2022]
Abstract
We propose a landmark-based, virtual coordinate system, specifically designed for assessment of asymmetrical craniofacial anatomy associated with unicoronal synostosis. Method CT scans of 33 patients with nonsyndromic unicoronal synostosis were included. Proposed mid-sagittal plane was compared with commonly used sagittal planes: (1) nasion, sella, and basion (N-S-BA); (2) midplane of bilateral frontozygomatic sutures (midFZ); and (3) the skull gravity center plane, to evaluate reliability and validity in the assessments of the anterior and posterior skull base. Results The proposed midplane is similar to the midFZ plane in describing the direction of the anterior skull base. However, it has less bias than the N-S-BA (P < 0.001), and the gravity center planes (P < 0.001). The proposed midplane measures the direction of the posterior skull base plane, similar to the midFZ and gravity center planes, but it has less measurement deviation than the N-S-BA plane (P < 0.001). The most protrusive point on the frontal bone in unicoronal patients is contralateral to the fused suture and distant from the mid-sagittal plane by 13.93 ± 4.01 mm. In addition, it is more anteriorly positioned, by 5.32 mm (P < 0.001), when compared with the corresponding point on the synostotic side. The uppermost point of the supraorbital rim on the synostotic side is cephalic to that of the contralateral side by 4.09 mm (P < 0.001). Conclusions Prioritized orientation of an averaged Frankfort horizontal plane, followed by the location of the mid-sagittal and coronal planes, can generate a reliable and valid coordinate framework for the assessment of asymmetric skull shape in unicoronal synostosis.
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Neurological Functional Connectivity in Unilateral Coronal Synostosis: A Side-Based Comparison. J Craniofac Surg 2020; 32:910-914. [PMID: 33252527 DOI: 10.1097/scs.0000000000007274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Unicoronal synostosis (UCS) has been associated with reading, language, and social dysfunction. Limited brain function connectivity studies exist for UCS with none devoted to comparing outcomes by side of synostosis (left versus right-sided UCS). METHODS Twelve patients with surgically treated UCS, 7 right-sided and 5 left-sided, were age matched to healthy controls. Resting state functional MRI was acquired in a 3T Siemens TIM Trio scanner (Erlangen, Germany). Data was collected with intrinsic connectivity distribution and seed-connectivity analysis using BioImage Suite (Yale School of Medicine). Region of interest analysis was performed based on Brodmann areas related to emotional, executive, language, motor, and visuo-spatial function. Significance was set at P < 0.05. RESULTS Compared to controls, all UCS patients demonstrated decreased connectivity in areas of the parietal and temporal cortices responsible for visuo-motor coordination and language function. Right UCS patients demonstrated decreased intrinsic connectivity in regions related to complex motor movement and proprioception relative to control subjects. Left UCS patients demonstrated decreased seed connectivity between regions of the parietal lobe and occipital lobe related to motor coordination, visual function, and language compared to right UCS patients. CONCLUSION Unicoronal synostosis had decreased functional connectivity in regions associated with memory, visual information processing, and motor function. Moreover, left-sided UCS had decreased connectivity in circuits for motor coordination and language when compared to right-sided UCS. This study provides data suggestive of long-term sequelae of UCS that varies by sidedness, which may be responsible for neurocognitive impairments found in previous cognitive analyses.
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Technical Strategy Using Piezosurgery to Correct Flattened Supraorbital Rim in Unilateral Coronal Craniosynostosis. J Craniofac Surg 2020; 32:97-100. [PMID: 33156179 DOI: 10.1097/scs.0000000000007017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The surgical correction of orbital deformities in patients with unilateral coronal craniosynostosis is challenging. Traditional techniques have shown the persistence of orbital flattening. This study presents a new strategy for remodeling the compromised orbit, using the piezosurgery technique, which improves the orbital curvature.
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Rizell S, Karlsson P, Ransjö M, Westerlund A, Yehia Z, Kölby L. Lateral and Frontal Cephalometric Measurements in a Cohort With Saethre-Chotzen Syndrome. Cleft Palate Craniofac J 2020; 58:838-846. [PMID: 33153317 DOI: 10.1177/1055665620969292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Descriptions of the craniofacial morphology in Saethre-Chotzen syndrome (SCS) are primarily based on case reports or visual assessments of affected families. The aim of this study was to compare cephalometric measurements of the craniofacial skeleton in a cohort of individuals with SCS and age- and sex-matched individuals without craniofacial anomalies. DESIGN Retrospective case series. PATIENTS Eight girls and 4 boys with SCS (age range, 7.0-19.2 years). METHODS Cephalometric measurements were performed using lateral and frontal cephalograms. RESULTS Most of the individuals with Saethre-Chotzen syndrome exhibited lower values for SNA, SNB, s-n and s-ar, while their NSL/NL, NSL/ML, NL/ML, and n-s-ba values were higher than the respective mean reference values for healthy individuals. In comparison with age- and sex-matched individuals without craniofacial anomalies, the individuals with SCS showed higher values for the maxillary and mandibular angular measurements, as well as for the menton midline angle. CONCLUSIONS This sample of 12 unrelated individuals with SCS is the largest collected to date for cephalometric measurements. We found that the syndrome is associated with bimaxillary retrognathism, posterior maxillary and mandibular inclination, neutral sagittal relation as well as a tendency toward an open vertical skeletal relation, a short and flattened skull base, and facial asymmetry, as compared to individuals without the syndrome.
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Affiliation(s)
- Sara Rizell
- Clinic of Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Sweden
| | - Peter Karlsson
- Fjärås Public Dental Service Clinic, 3572Region Västra Götaland, Sweden
| | - Maria Ransjö
- Department of Orthodontics, Institute of Odontology, The Sahlgrenska Academy, 3570University of Gothenburg, Sweden
| | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, The Sahlgrenska Academy, 3570University of Gothenburg, Sweden
| | - Zakaria Yehia
- Fridhemsplan Public Dental Service Clinic, 7674Region Stockholm, Stockholm, Sweden
| | - Lars Kölby
- The Sahlgrenska Academy, 3570University of Gothenburg and Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
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Öwall L, Darvann TA, Hove HB, Heliövaara A, Dunø M, Kreiborg S, Hermann NV. Facial Asymmetry in Nonsyndromic and Muenke Syndrome-Associated Unicoronal Synostosis: A 3-Dimensional Study Based on Facial Surfaces Extracted From CT Scans. Cleft Palate Craniofac J 2020; 58:687-696. [PMID: 32969272 DOI: 10.1177/1055665620959983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To quantify soft tissue facial asymmetry (FA) in children with nonsyndromic and Muenke syndrome-associated unicoronal synostosis (NS-UCS and MS-UCS), hypothesizing that MS-UCS presents with significantly larger FA than NS-UCS. DESIGN Retrospective cohort study. PATIENTS AND METHODS Twenty-one children (mean age: 0.6 years; range: 0.1-1.4 years) were included in the study (NS-UCS = 14; MS-UCS = 7). From presurgical computed tomography scans, facial surfaces were constructed for analysis. A landmark guided atlas was deformed to match each patient's surface, obtaining spatially detailed left-right point correspondence. Facial asymmetry was calculated in each surface point across the face, as the length (mm) of an asymmetry vector, with its Cartesian components providing 3 directions. Mean FA was calculated for the full face, and the forehead, eye, nose, cheek, mouth, and chin regions. RESULTS For the full face, a significant difference of 2.4 mm (P = .001) was calculated between the 2 groups, predominately in the transverse direction (1.5 mm; P < .001). The forehead and chin regions presented with the largest significant difference, 3.5 mm (P = .002) and 3.2 mm (P < .001), respectively; followed by the eye (2.4 mm; P = .004), cheek (2.2 mm; P = .004), nose (1.7 mm; P = .001), and mouth (1.4 mm; P = .009) regions. The transverse direction presented with the largest significant difference in the forehead, chin, mouth, and nose regions, the sagittal direction in the cheek region, and the vertical direction in the eye region. CONCLUSIONS Muenke syndrome-associated unicoronal synostosis presented with significantly larger FA in all regions compared to NS-UCS. The largest significant differences were found in the forehead and chin regions, predominantly in the transverse direction.
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Affiliation(s)
- Louise Öwall
- 3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen, Center of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, and DTU Compute, Technical University of Denmark), Copenhagen, Denmark
| | - Tron A Darvann
- 3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen, Center of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, and DTU Compute, Technical University of Denmark), Copenhagen, Denmark.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hanne B Hove
- Center for Rare Diseases, Department of Pediatrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,The RAREDIS Database, Center for Rare Diseases, Department of Pediatrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Arja Heliövaara
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Morten Dunø
- Center for Rare Diseases, Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sven Kreiborg
- 3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen, Center of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, and DTU Compute, Technical University of Denmark), Copenhagen, Denmark.,Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Nuno V Hermann
- 3D Craniofacial Image Research Laboratory (School of Dentistry, University of Copenhagen, Center of Head and Orthopedics, Copenhagen University Hospital Rigshospitalet, and DTU Compute, Technical University of Denmark), Copenhagen, Denmark.,Department of Pediatric Dentistry and Clinical Genetics, School of Dentistry, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
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Implementing Patient-Reported Outcome Measures in Routine Cleft-Craniofacial Practice. J Craniofac Surg 2020; 32:366-367. [PMID: 32956315 DOI: 10.1097/scs.0000000000007015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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