1
|
Satanin LA, Evteev AA, Rudnev SG, Satanina TL, Roginsky VV. Normative reference data for intracranial volume in children: The results of CT volumetry. Childs Nerv Syst 2024; 40:1873-1879. [PMID: 38393384 DOI: 10.1007/s00381-024-06318-7] [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: 12/24/2023] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Intracranial volume (ICV) is an important indicator of the development of the brain and skull in children. At present, there is a lack of ICV growth standards based on large infant and children samples. Our aim was to assess the normal range of the ICV variation in Russian children using a modern automatic system for constructing the endocranial cavity (Endex) and to provide growth standards of the ICV for clinical practice. METHODS High-resolution head CT scans were obtained from 673 apparently healthy children (380 boys and 293 girls) aged 0-17 years and transformed into the ICV estimates using the Endex software. The open-source software RefCurv utilizing R and the GAMLSS add-on package with the LMS method was then used for the construction of smooth centile growth references for ICV according to age and sex. RESULTS We demonstrated that the ICVs estimates calculated using the Endex software are perfectly comparable with those obtained by a conventional technique (i.e. seed feeling). Sex-specific pediatric growth charts for ICV were constructed. CONCLUSIONS This study makes available for use in clinical practice ICV growth charts for the age from 0 to 17 based on a sample of 673 high-resolution CT images.
Collapse
Affiliation(s)
- L A Satanin
- Department of Pediatric Neurosurgery, Burdenko National Medical Research Center for Neurosurgery, Moscow, Russia.
| | - A A Evteev
- Anuchin Research Institute and Museum of Anthropology, Lomonosov Moscow State University, Moscow, Russia
| | - S G Rudnev
- Marchuk Institute of Numerical Mathematics, Russian Academy of Sciences, Moscow, Russia
| | - T L Satanina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - V V Roginsky
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| |
Collapse
|
2
|
Al-Murad BM, Radwan MA, Zaki IA, Soliman MM, Al-Shareef EM, Gaban AM, Al-Mukhlifi YM, Kefi FZ. Exploring Different Management Modalities of Nonsyndromic Craniosynostosis. Cureus 2024; 16:e60831. [PMID: 38910614 PMCID: PMC11190809 DOI: 10.7759/cureus.60831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Craniosynostosis is an atypical skull shape characterized by the premature fusion of cranial sutures. It is one of the most common congenital anomalies encountered by craniofacial surgeons, with a prevalence of one in every 2000-2500 births. It is classified into two main types: syndromic and nonsyndromic. In syndromic, the patient presents with other abnormalities involving the trunk, face, or extremities. While in nonsyndromic the only anomy is the premature fusion, which usually involves one suture; the most common subtypes are unicoronal, sagittal, bicoronal, metopic, and lambdoid. As a consequence, premature fusion before its natural time restricts the space for the brain to grow, increases intracranial pressure, causes damage to the brain tissue, and affects the development of the child. This review comprehensively provides a detailed overview of nonsyndromic craniosynostosis and aims to highlight the importance of early and accurate diagnosis, and determining the most suitable intervention, whether surgical or conservative modalities. The optimal treatment approach produces the most favorable aesthetic and functional outcomes.
Collapse
Affiliation(s)
| | | | - Ibrahim A Zaki
- General Practice of Pediatrics, Batterjee Medical College, Jeddah, SAU
| | | | | | | | - Yara M Al-Mukhlifi
- Medical School, King Saud Bin Abdualziz University for Health and Sciences, Riyadh, SAU
| | - Fatma Z Kefi
- Medical School, Batterjee Medical College, Jeddah , SAU
| |
Collapse
|
3
|
Brandao MM, Tonello C, Parizotto I, Machado LB, Alonso N. Analysis of intracranial pressure waveform using a non-invasive method in individuals with craniosynostosis. Childs Nerv Syst 2024; 40:145-152. [PMID: 37493721 DOI: 10.1007/s00381-023-06092-y] [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: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE Craniosynostosis can lead to symptoms resulting from cranial compliance (CC) changes and intracranial hypertension (ICH), which may cause cognitive and visual impairment. Non-invasive methods have emerged, including a new device that captures and processes the intracranial pressure waveform (ICPw) by the skull's oscillation. The present study evaluates ICPw obtained non-invasively (NIICPw) in patients with craniosynostosis. METHODS This prospective, cross-sectional, and descriptive study was conducted at a single center. Patients diagnosed with craniosynostosis and who provided informed consent were included. A US Food and Drug Administration-approved mechanical extensometer device (Brain4Care Corp.) was used to obtain a NIICPw. An ophthalmologist did a point-of-care retinography to check the optic nerve papilla. The P2/P1 ratio and the morphology of the NIICPw were analyzed, as well as the retinography. RESULTS Thirty-five patients were evaluated, and 42 registers were obtained because seven were assessed before and after the surgery. The two patients who presented papilledema had low CC (NIICPw shape Class 3 or 4). There was a significant association between NIICPw and papilledema. CONCLUSION The ratio P2/P1 and the NIICPw morphology provided by a non-invasive monitor are related to CC changes before papilledema occurs. This is especially useful in patients with craniosynostosis because invasive ICP monitoring is not always feasible. Further studies are warranted to establish the clinical utility of NIICPw in patients with craniosynostosis.
Collapse
Affiliation(s)
- Michele Madeira Brandao
- Hospital of Rehabilitation of Craniofacial Anomalies of the University of São Paulo, São Paulo, Bauru, Brazil.
| | - Cristiano Tonello
- Hospital of Rehabilitation of Craniofacial Anomalies of the University of São Paulo, São Paulo, Bauru, Brazil
| | - Isabella Parizotto
- Hospital of Rehabilitation of Craniofacial Anomalies of the University of São Paulo, São Paulo, Bauru, Brazil
| | - Luciano Brandao Machado
- Hospital of Rehabilitation of Craniofacial Anomalies of the University of São Paulo, São Paulo, Bauru, Brazil
| | - Nivaldo Alonso
- Hospital of Rehabilitation of Craniofacial Anomalies of the University of São Paulo, São Paulo, Bauru, Brazil
| |
Collapse
|
4
|
Elkhill C, Liu J, Linguraru MG, LeBeau S, Khechoyan D, French B, Porras AR. Geometric learning and statistical modeling for surgical outcomes evaluation in craniosynostosis using 3D photogrammetry. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107689. [PMID: 37393741 PMCID: PMC10527531 DOI: 10.1016/j.cmpb.2023.107689] [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: 01/18/2023] [Revised: 05/11/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Accurate and repeatable detection of craniofacial landmarks is crucial for automated quantitative evaluation of head development anomalies. Since traditional imaging modalities are discouraged in pediatric patients, 3D photogrammetry has emerged as a popular and safe imaging alternative to evaluate craniofacial anomalies. However, traditional image analysis methods are not designed to operate on unstructured image data representations such as 3D photogrammetry. METHODS We present a fully automated pipeline to identify craniofacial landmarks in real time, and we use it to assess the head shape of patients with craniosynostosis using 3D photogrammetry. To detect craniofacial landmarks, we propose a novel geometric convolutional neural network based on Chebyshev polynomials to exploit the point connectivity information in 3D photogrammetry and quantify multi-resolution spatial features. We propose a landmark-specific trainable scheme that aggregates the multi-resolution geometric and texture features quantified at every vertex of a 3D photogram. Then, we embed a new probabilistic distance regressor module that leverages the integrated features at every point to predict landmark locations without assuming correspondences with specific vertices in the original 3D photogram. Finally, we use the detected landmarks to segment the calvaria from the 3D photograms of children with craniosynostosis, and we derive a new statistical index of head shape anomaly to quantify head shape improvements after surgical treatment. RESULTS We achieved an average error of 2.74 ± 2.70 mm identifying Bookstein Type I craniofacial landmarks, which is a significant improvement compared to other state-of-the-art methods. Our experiments also demonstrated a high robustness to spatial resolution variability in the 3D photograms. Finally, our head shape anomaly index quantified a significant reduction of head shape anomalies as a consequence of surgical treatment. CONCLUSION Our fully automated framework provides real-time craniofacial landmark detection from 3D photogrammetry with state-of-the-art accuracy. In addition, our new head shape anomaly index can quantify significant head phenotype changes and can be used to quantitatively evaluate surgical treatment in patients with craniosynostosis.
Collapse
Affiliation(s)
- Connor Elkhill
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Department of Pediatric Plastic and Reconstructive Surgery, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA.
| | - Jiawei Liu
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Marius George Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, 7144 13th Pl NW, Washington, DC 20012, USA; Departments of Radiology and Pediatrics, George Washington University School of Medicine and Health Sciences, Ross Hall, 2300 Eye Street, NW, Washington, DC 20037, USA
| | - Scott LeBeau
- Department of Pediatric Plastic and Reconstructive Surgery, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA
| | - David Khechoyan
- Department of Pediatric Plastic and Reconstructive Surgery, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA; Department of Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA
| | - Brooke French
- Department of Pediatric Plastic and Reconstructive Surgery, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA; Department of Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA
| | - Antonio R Porras
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Department of Pediatric Plastic and Reconstructive Surgery, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA; Department of Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA; Department of Biomedical Informatics, School of Medicine, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA; Department of Pediatrics and Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO 80045, USA
| |
Collapse
|
5
|
Park TH, Ryu JY, Lee JS, Yang JD, Chung HY, Cho BC, Choi KY. Effectiveness of immediate fixation after cranial distraction osteogenesis. J Plast Reconstr Aesthet Surg 2023; 77:274-283. [PMID: 36592539 DOI: 10.1016/j.bjps.2022.11.011] [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: 05/09/2022] [Revised: 10/18/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Distraction osteogenesis (DO) is an established safe and effective treatment of craniosynostosis (CS) deformities. However, conventional methods demonstrate some complications, such as long-term maintenance of the distractor and relapse after distractor removal. Only a few studies have overcome these limitations. Therefore, we hypothesized that placing a resorbable plate after removing the distractor will provide additional stability to the newly formed bone, shortening the consolidation period and minimizing relapse. METHODS Twenty-six children diagnosed with CS who underwent DO between 2000 and 2019 were retrospectively analyzed. A resorbable plate was fixed across the regenerated bone when distractors were removed. The consolidation period and complication rate were obtained from medical records, and both two- and three-dimensional analyses were performed to obtain relapse rate and brain volume changes using three-dimensional computed tomography. RESULTS Among 26 patients, the average consolidation period was 90.75±23.75 days in the conventional group (n = 11) and 22.77±8.69 days in the intervention group (n = 15). In the two-dimensional analysis, the relapse rate was lower in the intervention group. Moreover, in the three-dimensional analysis, the relapse rate of unilateral CS between the affected and unaffected sides was lower in the intervention group. The conventional group had more complications (skin defect and distractor exposure). CONCLUSION Resorbable plate placement after distractor removal helps shorten the consolidation period and prevent relapse in pediatric patients with cranial DO. It reduces complications and shows stable results in terms of cranial morphology and symmetric brain growth in patients with CS.
Collapse
Affiliation(s)
- Tae Hyun Park
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, South Korea
| | - Jeong Yeop Ryu
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, South Korea
| | - Joon Seok Lee
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, South Korea
| | - Jung Dug Yang
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, South Korea
| | - Ho Yun Chung
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, South Korea
| | - Byung Chae Cho
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, South Korea
| | - Kang Young Choi
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, South Korea.
| |
Collapse
|
6
|
Intracranial Volumes of Healthy Children in the First 3 Years of Life: An Analysis of 270 Magnetic Resonance Imaging Scans. Plast Reconstr Surg 2022; 150:136e-144e. [PMID: 35575631 DOI: 10.1097/prs.0000000000009188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is a paucity of data on normal intracranial volumes for healthy children during the first few years of life, when cranial growth velocity is greatest. The aim of this study was to generate a normative predictive model of intracranial volumes based on brain magnetic resonance imaging from a large sample of healthy children to serve as a reference tool for future studies on craniosynostosis. METHODS Structural magnetic resonance imaging data for healthy children up to 3 years of age was acquired from the National Institutes of Health Pediatric MRI Data Repository. Intracranial volumes were calculated using T1-weighted scans with FreeSurfer (version 6.0.0). Mean intracranial volumes were calculated and best-fit logarithmic curves were generated. Results were compared to previously published intracranial volume curves. RESULTS Two-hundred seventy magnetic resonance imaging scans were available: 118 were collected in the first year of life, 97 were collected between years 1 and 2, and 55 were collected between years 2 and 3. A best-fit logarithmic growth curve was generated for male and female patients. The authors' regression models showed that male patients had significantly greater intracranial volumes than female patients after 1 month of age. Predicted intracranial volumes were also greater in male and female patients in the first 6 months of life as compared to previously published intracranial volume curves. CONCLUSIONS To the authors' knowledge, this is the largest series of demographically representative magnetic resonance imaging-based intracranial volumes for children aged 3 years and younger. The model generated in this study can be used by investigators as a reference for evaluating craniosynostosis patients.
Collapse
|
7
|
Objective Analysis of Fronto-Orbital Dysmorphology in Unilateral Coronal Craniosynostosis. J Craniofac Surg 2021; 32:2266-2272. [PMID: 34101692 DOI: 10.1097/scs.0000000000007748] [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] Open
Abstract
ABSTRACT Correction (and over-correction) of asymmetries of the orbital shape and brow position in unilateral coronal craniosynostosis (UCS) is critical to successful fronto-orbital advancement. Here we quantify and three-dimensionally assess fronto-orbital irregularities in UCS patients compared to controls.Twenty-three patients with UCS evaluated at the Children's Hospital of Pittsburgh between 2006 and 2016 were age and gender-matched to controls. Computed tomography scans were reconstructed and evaluated for orbital metrics. A three-dimensional heat map of orbital regions was generated and evaluated for shape differences.Brow protrusion of the orbit ipsilateral to the synostotic suture did not differ significantly from healthy controls. Orbital height was significantly increased while orbital width was decreased on the UCS ipsilateral side compared to the contralateral side and controls. The ipsilateral cornea was overprojected relative to the brow and the infraorbital rim, but similar to controls relative to the lateral rim. The contralateral orbit had increased brow protrusion with decreased orbital height. The cornea was underprojected relative to the brow, but overprojected relative to the lateral orbital rim and similar to controls at the infraorbital rim. Three-dimensional comparison demonstrated significant overprojection of the contralateral brow, with some more mild and inconsistent underprojection of the lateral aspect of the ipsilateral brow.Key orbital and brow differences exist between the affected and unaffected sides in UCS. This study provides quantitative data that further characterize the orbital dysmorphology observed in UCS and identifies unique aspects of the diagnosis that should be taken into consideration during surgical planning.
Collapse
|
8
|
Calandrelli R, Pilato F, Marrazzo A, Massimi L, Panfili M, Di Rocco C, Colosimo C. Computer tomography-based quantitative analysis of the orbital proptosis severity in infants with syndromic craniosynostosis: case-control study. Childs Nerv Syst 2021; 37:1659-1668. [PMID: 33559055 DOI: 10.1007/s00381-021-05062-6] [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: 12/09/2020] [Accepted: 01/25/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Evaluation of orbital proptosis and sutural synostosis pattern along the coronal ring in craniofaciosynostosis patients with or without fibroblastic growth factor receptor 2 (FGFR2) mutation. METHODS High-resolution computer tomography was used to assess, in children with or without FGFR2 mutation, the early synostotic involvement of the "major" and "minor" sutures/synchondroses of the coronal arch along with the following orbital parameters: interorbital angle, bone orbital cavity volume, globe volume, ventral globe volume, ventral globe index. RESULTS Infants with FGFR2 mutation showed an increased number of closed minor sutures/synchondroses along the posterior coronal branch while both groups showed a comparable synostotic involvement of the minor sutures of the anterior coronal branch. FGFR2 infants with posterior coronal branch synostotic involvement showed a higher degree of proptosis due to both reduced bony cavity volume and increased globe volume (p<0.05). CONCLUSIONS Our data show that FGFR2 mutation together with posterior coronal branch synostotic involvement has a synergic effect in causing a more severe degree of orbital proptosis.
Collapse
Affiliation(s)
- Rosalinda Calandrelli
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma-UOC Radiologia e Neuroradiologia, Polo Diagnostica per immagini, radioterapia, oncologia ed ematologia, Area diagnostica per immagini, Largo Francesco Vito 1, -00168, Rome, Italy.
| | - Fabio Pilato
- Unit of Neurology, Neurophysiology, Department of Medicine, University Campus Bio-Medico, via Álvaro del Portillo 21, 00128, Rome, Italy
| | - Antonio Marrazzo
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma-UOC Radiologia e Neuroradiologia, Polo Diagnostica per immagini, radioterapia, oncologia ed ematologia, Area diagnostica per immagini, Largo Francesco Vito 1, -00168, Rome, Italy
| | - Luca Massimi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma -UOC Neurochirurgia Infantile - Polo scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Area Neuroscienze, Rome, Italy.,Università Cattolica del Sacro Cuore, Istituto di Neurochirurgia, Rome, Italy
| | - Marco Panfili
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma-UOC Radiologia e Neuroradiologia, Polo Diagnostica per immagini, radioterapia, oncologia ed ematologia, Area diagnostica per immagini, Largo Francesco Vito 1, -00168, Rome, Italy
| | | | - Cesare Colosimo
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma-UOC Radiologia e Neuroradiologia, Polo Diagnostica per immagini, radioterapia, oncologia ed ematologia, Area diagnostica per immagini, Largo Francesco Vito 1, -00168, Rome, Italy.,Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
| |
Collapse
|
9
|
Tu L, Porras AR, Enquobahrie A, Buck B S GC, Tsering M S D, Horvath S, Keating R, Oh AK, Rogers GF, George Linguraru M. Automated Measurement of Intracranial Volume Using Three-Dimensional Photography. Plast Reconstr Surg 2020; 146:314e-323e. [PMID: 32459727 DOI: 10.1097/prs.0000000000007066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current methods to analyze three-dimensional photography do not quantify intracranial volume, an important metric of development. This study presents the first noninvasive, radiation-free, accurate, and reproducible method to quantify intracranial volume from three-dimensional photography. METHODS In this retrospective study, cranial bones and head skin were automatically segmented from computed tomographic images of 575 subjects without cranial abnormality (average age, 5 ± 5 years; range, 0 to 16 years). The intracranial volume and the head volume were measured at the cranial vault region, and their relation was modeled by polynomial regression, also accounting for age and sex. Then, the regression model was used to estimate the intracranial volume of 30 independent pediatric patients from their head volume measured using three-dimensional photography. Evaluation was performed by comparing the estimated intracranial volume with the true intracranial volume of these patients computed from paired computed tomographic images; two growth models were used to compensate for the time gap between computed tomographic and three-dimensional photography. RESULTS The regression model estimated the intracranial volume of the normative population from the head volume calculated from computed tomographic images with an average error of 3.81 ± 3.15 percent (p = 0.93) and a correlation (R) of 0.96. The authors obtained an average error of 4.07 ± 3.01 percent (p = 0.57) in estimating the intracranial volume of the patients from three-dimensional photography using the regression model. CONCLUSION Three-dimensional photography with image analysis provides measurement of intracranial volume with clinically acceptable accuracy, thus offering a noninvasive, precise, and reproducible method to evaluate normal and abnormal brain development in young children. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, V.
Collapse
Affiliation(s)
- Liyun Tu
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Antonio R Porras
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Andinet Enquobahrie
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Graham C Buck B S
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Deki Tsering M S
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Samantha Horvath
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Robert Keating
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Albert K Oh
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Gary F Rogers
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| | - Marius George Linguraru
- From the Sheikh Zayed Institute for Pediatric Surgical Innovation, the Division of Neurosurgery, and the Division of Plastic and Reconstructive Surgery, Children's National Hospital; Kitware, Inc.; and the Departments of Radiology and Pediatrics, School of Medicine and Health Sciences, George Washington University
| |
Collapse
|
10
|
Abstract
BACKGROUND Apert syndrome causes normal or enlarged intracranial volume overall as patients grow. This study aimed to trace the segmental anterior, middle, and posterior cranial fossae volume and structural morphology in these patients, to help discern a more focused and individualized surgical treatment plan for patients with Apert syndrome. METHODS This study included 82 preoperative computed tomographic scans (Apert, n = 32; control, n = 50) divided into five age-related subgroups. The scans were measured using image processing and three-dimensional modeling software. RESULTS The middle cranial fossa volume was increased and was the earliest change noted. It was increased by 45 percent (p = 0.023) compared with controls before 6 months of age and remained increased into adulthood (161 percent, p = 0.016), with gradually increasing severity. The anterior and posterior cranial fossae volumes also increased, by 35 percent (p = 0.032) and 39 percent (p = 0.007), respectively. Increased depth of cranial fossae contributed most to the increase in volumes of patients with Apert syndrome, with correlation coefficients of 0.799, 0.908, and 0.888 for anterior, middle, and posterior cranial fossa, respectively. The intracranial volume was increased 12 percent (p = 0.098) across the entire test age range (0 to 26 years old), but only had statistical significance during the age range of 6 to 18 years (22 percent, p = 0.001). CONCLUSIONS Malformation of the middle cranial fossa is an early, perhaps the initial, pivotal cranial morphologic change in Apert syndrome. Increased cranial fossae depth is an inherent characteristic of the maldevelopment. Normalization of cranial volume and circumference overall may not achieve a normal skull structure, as it does not correct regional craniocerebral disproportion.
Collapse
|
11
|
Orbito-facial dysmorphology in patients with different degrees of trigonocephaly severity: quantitative morpho-volumetric analysis in infants with non-syndromic metopic craniosynostosis. Childs Nerv Syst 2020; 36:1263-1273. [PMID: 31845029 DOI: 10.1007/s00381-019-04456-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 11/27/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE Craniofacial dysmorphology varies significantly along a wide spectrum of severity in metopic cranial synostosis (MCS). This study aimed to quantify craniofacial changes, in MCS, to investigate their relationships with the severity of trigonocephaly. METHODS By combining the metopic ridge and interfrontal angles, we identified three groups of trigonocephaly severity (mild group n.14, moderate group n.19, severe group n.18). We perform a quantitative analysis using high-resolution CT images evaluating (1) cranial fossae dimensions; (2) vault indices and ratios: interparietal/ intercoronal (IPD/ICD), interparietal/intertemporal (IPD/ITD), cephalic index, vertico-longitudinal index; (3) orbito-facial distances (midfacial depth, maxillary height, upper facial index, orbital distances, globe protrusions), maxilla and orbital volumes; (4) supratentorial (ICV) and infratentorial (PCFV) cranial volumes and supratentorial (WBV) and infratentorial (PCFBV) brain volumes. RESULTS In all groups, middle skull base lengths and upper midface index were increased. In moderate and severe groups: anterior hemifossa lengths were reduced, IPD/ICD and vertico-longitudinal index were changed; midfacial depth, anterior, mild, and lateral interorbital distances were reduced; globe protrusions were increased. The comparison between moderate and severe groups showed an increase of both globe protrusions and IPD/ICD. Among all groups, ICV and WBV were reduced in the severe group. CONCLUSION This morpho-volumetric study provides new insights in understanding the craniofacial changes occurring in infants at different severity of trigonocephaly. The increase of globe protrusions and the reduction of supratentorial volumes found in the severe group reflect the severity of trigonocephaly; these findings might have a clinical and surgical relevance.
Collapse
|
12
|
Quantification of Head Shape from Three-Dimensional Photography for Presurgical and Postsurgical Evaluation of Craniosynostosis. Plast Reconstr Surg 2020; 144:1051e-1060e. [PMID: 31764657 DOI: 10.1097/prs.0000000000006260] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evaluation of surgical treatment for craniosynostosis is typically based on subjective visual assessment or simple clinical metrics of cranial shape that are prone to interobserver variability. Three-dimensional photography provides cheap and noninvasive information to assess surgical outcomes, but there are no clinical tools to analyze it. The authors aim to objectively and automatically quantify head shape from three-dimensional photography. METHODS The authors present an automatic method to quantify intuitive metrics of local head shape from three-dimensional photography using a normative statistical head shape model built from 201 subjects. The authors use these metrics together with a machine learning classifier to distinguish between patients with (n = 266) and without (n = 201) craniosynostosis (aged 0 to 6 years). The authors also use their algorithms to quantify objectively local surgical head shape improvements on 18 patients with presurgical and postsurgical three-dimensional photographs. RESULTS The authors' methods detected craniosynostosis automatically with 94.74 percent sensitivity and 96.02 percent specificity. Within the data set of patients with craniosynostosis, the authors identified correctly the fused sutures with 99.51 percent sensitivity and 99.13 percent specificity. When the authors compared quantitatively the presurgical and postsurgical head shapes of patients with craniosynostosis, they obtained a significant reduction of head shape abnormalities (p < 0.05), in agreement with the treatment approach and the clinical observations. CONCLUSIONS Quantitative head shape analysis and three-dimensional photography provide an accurate and objective tool to screen for head shape abnormalities at low cost and avoiding imaging with radiation and/or sedation. The authors' automatic quantitative framework allows for the evaluation of surgical outcomes and has the potential to detect relapses. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, I.
Collapse
|
13
|
Quantification of Head Shape and Cranioplasty Outcomes: Six-compartment Volume Method Applied to Sagittal Synostosis. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2171. [PMID: 31321176 PMCID: PMC6554154 DOI: 10.1097/gox.0000000000002171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/08/2019] [Indexed: 12/05/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Premature fusion of the sagittal (midline) suture between 2 parietal bones is the most common form of craniosynostosis. Surgical correction is mandated to improve head shape and to decrease the risk of raised intracranial pressure. This study evaluated the utility of 3-dimensional (3D) imaging to quantify the volumetric changes of surgical correction. Currently there is no standardized method used to quantify the outcomes of surgery for craniosynostosis, with the cranial index (width: length ratio) being commonly used. Methods: A method for quantification of head shape using 3D imaging is described in which the cranium is divided up into 6 compartments and the volumes of 6 compartments are quantified and analyzed. The method is size invariant, meaning that it can be used to assess the long-term postoperative outcomes of patients through growth. The method is applied to a cohort of sagittal synostosis patients and a normal cohort, and is used to follow up a smaller group of synostotic patients 1, 2, and 3 years postoperatively. Results: Statistical analysis of the results shows that the 6-compartment volume quantification method is more accurate in separating normal from synostotic patient head shapes than the cranial index. Conclusions: Spring-mediated cranioplasty does not return head shape back to normal, but results in significant improvements in the first year following surgery compared with the preoperative sagittal synostosis head shape. 3D imaging can be a valuable tool in assessing the volumetric changes due to surgery and growth in craniosynstosis patients.
Collapse
|
14
|
Abdullah JY, Rajion ZA, Martin AG, Jaafar A, Ghani ARI, Abdullah JM. Shape-based interpolation method in measuring intracranial volume for pre- and post-operative decompressive craniectomy using open source software. Neurocirugia (Astur) 2019; 30:115-123. [PMID: 30782505 DOI: 10.1016/j.neucir.2018.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/25/2018] [Accepted: 12/01/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Intracranial volume (ICV) is an important tool in the management of patients undergoing decompressive craniectomy (DC) surgery. The aim of this study was to validate ICV measurement applying the shape-based interpolation (SBI) method using open source software on computed tomography (CT) images. METHODS The pre- and post-operative CT images of 55 patients undergoing DC surgery were analyzed. The ICV was measured by segmenting every slice of the CT images, and compared with estimated ICV calculated using the 1-in-10 sampling strategy and processed using the SBI method. An independent t test was conducted to compare the ICV measurements between the two different methods. The calculation using this method was repeated three times for reliability analysis using the intraclass correlations coefficient (ICC). The Bland-Altman plot was used to measure agreement between the methods for both pre- and post-operative ICV measurements. RESULTS The mean ICV (±SD) were 1341.1±122.1ml (manual) and 1344.11±122.6ml (SBI) for the preoperative CT data. The mean ICV (±SD) were 1396.4±132.4ml (manual) and 1400.53±132.1ml (SBI) for the post-operative CT data. No significant difference was found in ICV measurements using the manual and the SBI methods (p=.983 for pre-op, and p=.960 for post-op). The intrarater ICC showed a significant correlation; ICC=1.00. The Bland-Altman plot showed good agreement between the manual and the SBI method. CONCLUSION The shape-based interpolation method with 1-in-10 sampling strategy gave comparable results in estimating ICV compared to manual segmentation. Thus, this method could be used in clinical settings for rapid, reliable and repeatable ICV estimations.
Collapse
Affiliation(s)
- Johari Yap Abdullah
- Craniofacial Medical Imaging Research Group, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Zainul Ahmad Rajion
- Craniofacial Medical Imaging Research Group, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
| | - Arvind Gerard Martin
- Department of Neurosurgery, Hospital Tengku Ampuan Afzan, Jalan Air Putih, Kuantan, Pahang, Malaysia
| | - Azlan Jaafar
- Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Abdul Rahman Izaini Ghani
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Jafri Malin Abdullah
- Centre for Neuroscience Services & Research, Universiti Sains Malaysia, Kelantan, Malaysia
| |
Collapse
|
15
|
Calandrelli R, Pilato F, Massimi L, Panfili M, Di Rocco C, Colosimo C. Quantitative analysis of cranial-orbital changes in infants with anterior synostotic plagiocephaly. Childs Nerv Syst 2018; 34:1725-1733. [PMID: 29761256 DOI: 10.1007/s00381-018-3824-8] [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: 03/22/2018] [Accepted: 05/04/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE The effects of premature fusion of one coronal suture cause skull and orbital alterations in term of side-to-side asymmetry. This study aimed to quantify the cranio-orbital complex changes related to the severity of skull base dysmorphology in patients with unicoronal synostosis. METHODS Twenty-four infants affected by unicoronal synostosis were subdivided in three subgroups according to the severity of skull base deformity and their high-resolution CT images were quantitatively analyzed (groups IIa, IIb, III). Dimensions of cranial fossae, intracranial volume (ICV), ICV synostotic and ICV non synostotic side, whole brain volume (WBV), orbital volumes (OV), ICV/WBV, ICVsynostotic/ICVnon-synostotic, and OVsynostotic/OVnon-synostotic were evaluated. RESULTS Asymmetry and reduction in the growth of the anterior and middle fossae were found in all groups while asymmetry of the posterior cranial fossa was found only in IIb and III groups. In all groups, ICV, WBV, and ICV/WBV were not significantly different while ICVsynostotic/ICVnon-synostotic and OVsynostotic/OVnon-synostotic resulted significant difference (p < 0.05). ICVsynostotic side resulted reduction only in group III. OV on the synostotic side was not significantly reduced although a trend in progressively reducing volumes was noted according to the severity of the group. CONCLUSION Skull and orbital changes revealed a side-to-side asymmetry but the effects of the premature synostosis were more severe in group III suggesting an earlier timing of premature unicoronal synostosis in group III with respect to the other groups. The assessment of the skull base deformity might be an indirect parameter of severity of skull orbital changes and it might be useful for surgical planning.
Collapse
Affiliation(s)
- Rosalinda Calandrelli
- Polo scienze delle immagini, di laboratorio ed infettivologiche Area diagnostica per immagini Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
| | - Fabio Pilato
- Polo scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Area neuroscienze Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Luca Massimi
- Polo scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Area neuroscienze Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Marco Panfili
- Polo scienze delle immagini, di laboratorio ed infettivologiche Area diagnostica per immagini Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Concezio Di Rocco
- Polo scienze dell'invecchiamento, neurologiche, ortopediche e della testa-collo, Area neuroscienze Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Cesare Colosimo
- Polo scienze delle immagini, di laboratorio ed infettivologiche Area diagnostica per immagini Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| |
Collapse
|
16
|
Libby J, Marghoub A, Johnson D, Khonsari RH, Fagan MJ, Moazen M. Modelling human skull growth: a validated computational model. J R Soc Interface 2018; 14:rsif.2017.0202. [PMID: 28566514 DOI: 10.1098/rsif.2017.0202] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 05/09/2017] [Indexed: 11/12/2022] Open
Abstract
During the first year of life, the brain grows rapidly and the neurocranium increases to about 65% of its adult size. Our understanding of the relationship between the biomechanical forces, especially from the growing brain, the craniofacial soft tissue structures and the individual bone plates of the skull vault is still limited. This basic knowledge could help in the future planning of craniofacial surgical operations. The aim of this study was to develop a validated computational model of skull growth, based on the finite-element (FE) method, to help understand the biomechanics of skull growth. To do this, a two-step validation study was carried out. First, an in vitro physical three-dimensional printed model and an in silico FE model were created from the same micro-CT scan of an infant skull and loaded with forces from the growing brain from zero to two months of age. The results from the in vitro model validated the FE model before it was further developed to expand from 0 to 12 months of age. This second FE model was compared directly with in vivo clinical CT scans of infants without craniofacial conditions (n = 56). The various models were compared in terms of predicted skull width, length and circumference, while the overall shape was quantified using three-dimensional distance plots. Statistical analysis yielded no significant differences between the male skull models. All size measurements from the FE model versus the in vitro physical model were within 5%, with one exception showing a 7.6% difference. The FE model and in vivo data also correlated well, with the largest percentage difference in size being 8.3%. Overall, the FE model results matched well with both the in vitro and in vivo data. With further development and model refinement, this modelling method could be used to assist in preoperative planning of craniofacial surgery procedures and could help to reduce reoperation rates.
Collapse
Affiliation(s)
- Joseph Libby
- Medical and Biological Engineering, School of Engineering and Computer Science, University of Hull, Hull HU6 7RX, UK
| | - Arsalan Marghoub
- UCL Mechanical Engineering, University College London, London WC1E 7JE, UK
| | - David Johnson
- Oxford Craniofacial Unit, Oxford Radcliffe Hospitals NHS Trust, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Roman H Khonsari
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Necker-Enfants Malades, Service de Chirurgie Maxillofaciale et Plastique & Université Paris Descartes, Paris, France
| | - Michael J Fagan
- Medical and Biological Engineering, School of Engineering and Computer Science, University of Hull, Hull HU6 7RX, UK
| | - Mehran Moazen
- UCL Mechanical Engineering, University College London, London WC1E 7JE, UK
| |
Collapse
|
17
|
Intracranial Volume Measurement: A Systematic Review and Comparison of Different Techniques. J Craniofac Surg 2017; 28:1746-1751. [DOI: 10.1097/scs.0000000000003929] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
18
|
Radiation-free 3D head shape and volume evaluation after endoscopically assisted strip craniectomy followed by helmet therapy for trigonocephaly. J Craniomaxillofac Surg 2017; 45:661-671. [DOI: 10.1016/j.jcms.2017.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/12/2016] [Accepted: 02/06/2017] [Indexed: 11/21/2022] Open
|
19
|
Rijken BFM, den Ottelander BK, van Veelen MLC, Lequin MH, Mathijssen IMJ. The occipitofrontal circumference: reliable prediction of the intracranial volume in children with syndromic and complex craniosynostosis. Neurosurg Focus 2015; 38:E9. [DOI: 10.3171/2015.2.focus14846] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
Patients with syndromic and complex craniosynostosis are characterized by the premature fusion of one or more cranial sutures. These patients are at risk for developing elevated intracranial pressure (ICP). There are several factors known to contribute to elevated ICP in these patients, including craniocerebral disproportion, hydrocephalus, venous hypertension, and obstructive sleep apnea. However, the causal mechanism is unknown, and patients develop elevated ICP even after skull surgery. In clinical practice, the occipitofrontal circumference (OFC) is used as an indirect measure for intracranial volume (ICV), to evaluate skull growth. However, it remains unknown whether OFC is a reliable predictor of ICV in patients with a severe skull deformity. Therefore, in this study the authors evaluated the relation between ICV and OFC.
METHODS
Eighty-four CT scans obtained in 69 patients with syndromic and complex craniosynostosis treated at the Erasmus University Medical Center-Sophia Children’s Hospital were included. The ICV was calculated based on CT scans by using autosegmentation with an HU threshold < 150. The OFC was collected from electronic patient files. The CT scans and OFC measurements were matched based on a maximum amount of the time that was allowed between these examinations, which was dependent on age. A Pearson correlation coefficient was calculated to evaluate the correlations between OFC and ICV. The predictive value of OFC, age, and sex on ICV was then further evaluated using a univariate linear mixed model. The significant factors in the univariate analysis were subsequently entered in a multivariate mixed model.
RESULTS
The correlations found between OFC and ICV were r = 0.908 for the total group (p < 0.001), r = 0.981 for Apert (p < 0.001), r = 0.867 for Crouzon-Pfeiffer (p < 0.001), r = 0.989 for Muenke (p < 0.001), r = 0.858 for Saethre- Chotzen syndrome (p = 0.001), and r = 0.917 for complex craniosynostosis (p < 0.001). Age and OFC were significant predictors of ICV in the univariate linear mixed model (p < 0.001 for both factors). The OFC was the only predictor that remained significant in the multivariate analysis (p < 0.001).
CONCLUSIONS
The OFC is a significant predictor of ICV in patients with syndromic and complex craniosynostosis. Therefore, measuring the OFC during clinical practice is very useful in determining which patients are at risk for impaired skull growth.
Collapse
Affiliation(s)
| | | | - Marie-Lise Charlotte van Veelen
- 3Department of Pediatric Neurosurgery, Erasmus University Medical Center–Sophia Children’s Hospital, Rotterdam, The Netherlands
| | | | | |
Collapse
|
20
|
Russell AJ, Patel KB, Skolnick G, Woo AS, Smyth MD. The path of the superior sagittal sinus in unicoronal synostosis. Childs Nerv Syst 2014; 30:1701-9. [PMID: 24578138 DOI: 10.1007/s00381-014-2384-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 02/06/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study investigates the anatomic relationship between the superior sagittal sinus (SSS) and the sagittal suture in infants with uncorrected unicoronal synostosis. The morphology of the SSS is also evaluated postoperatively to assess whether normalization of intracranial structures occurs following reconstruction. METHODS The study sample consisted of 20 computed tomography scans (10 preoperative, 6 postoperative, and 4 unaffected controls) obtained between 2001 and 2013. The SSS and the sagittal suture were outlined using Analyze imaging software. These data were used to measure the maximum lateral discrepancy between the SSS and the sagittal suture preoperatively and to assess for postoperative changes in the morphology of the SSS. RESULTS In children with uncorrected unicoronal synostosis, the SSS deviates to the side of the patent coronal suture posteriorly and tends to follow the path of the sagittal and metopic sutures. The lateral discrepancy between the SSS and the sagittal suture ranged from 5.0 to 11.8 mm, with a 99.9 % upper prediction bound of 14.4 mm. Postoperatively, the curvature of the SSS was statistically decreased following surgical intervention, though it remained significantly greater than in unaffected controls. CONCLUSIONS The SSS follows a predictable course relative to surface landmarks in children with unicoronal synostosis. When creating burr holes for craniotomies, the SSS can be avoided in 99.9 % of cases by remaining at least 14.4 mm from the lateral edge of the sagittal suture. Postoperative changes in the path of the SSS provide indirect evidence for normalization of regional brain morphology following fronto-orbital advancement.
Collapse
Affiliation(s)
- Aaron J Russell
- School of Medicine, Washington University, St. Louis, MO, USA,
| | | | | | | | | |
Collapse
|
21
|
The Impact of Age at Surgery on Long-Term Neuropsychological Outcomes in Sagittal Craniosynostosis. Plast Reconstr Surg 2014; 134:608e-617e. [DOI: 10.1097/prs.0000000000000511] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Khonsari R, Friess M, Nysjö J, Odri G, Malmberg F, Nyström I, Messo E, Hirsch J, Cabanis E, Kunzelmann K, Salagnac J, Corre P, Ohazama A, Sharpe P, Charlier P, Olszewski R. Shape and volume of craniofacial cavities in intentional skull deformations. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 151:110-9. [DOI: 10.1002/ajpa.22263] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 02/19/2013] [Indexed: 11/10/2022]
Affiliation(s)
| | - M. Friess
- Département Hommes; Natures, Sociétés & CNRS UMR 7206; Muséum National d'Histoire Naturelle; Musée de l'Homme; Paris; France
| | - J. Nysjö
- Centre for Image Analysis; Uppsala University; Uppsala; Sweden
| | - G. Odri
- Clinique Chirurgicale Orthopédique et Traumatologique; CHU Hôtel-Dieu; Nantes; France
| | - F. Malmberg
- Centre for Image Analysis; Uppsala University; Uppsala; Sweden
| | - I. Nyström
- Centre for Image Analysis; Uppsala University; Uppsala; Sweden
| | - E. Messo
- Department of Surgical Sciences, Oral and Maxillo-facial Surgery; Medical Faculty; Uppsala University; Uppsala; Sweden
| | - J.M. Hirsch
- Department of Surgical Sciences, Oral and Maxillo-facial Surgery; Medical Faculty; Uppsala University; Uppsala; Sweden
| | - E.A.M. Cabanis
- Service de Neuroradiologie; Centre Hospitalier National Ophtalmologique des XV-XX; Paris; France
| | - K.H. Kunzelmann
- Poliklinic für Zahnerhaltung und Parodontologie; Ludwig-Maximilians-Universität; Münich; Germany
| | - J.M. Salagnac
- Service de Chirurgie Maxillofaciale et Stomatologie; CHU Hôtel-Dieu; Nantes; France
| | - P. Corre
- Service de Chirurgie Maxillofaciale et Stomatologie; CHU Hôtel-Dieu; Nantes; France
| | - A. Ohazama
- Department of Craniofacial Development and Stem Cell Research; Dental Institute; King's College London; UK
| | - P.T. Sharpe
- Department of Craniofacial Development and Stem Cell Research; Dental Institute; King's College London; UK
| | - P. Charlier
- Service d'anatomopathologie; Hôpital Raymond-Poincaré; Garches; France
| | - R. Olszewski
- Service de Chirurgie Maxillofaciale et Stomatologie; Hôpital Saint-Luc, Université Catholique de Louvain; Bruxelles; Belgique
| |
Collapse
|
23
|
Ritvanen AG, de Oliveira ME, Koivikko MP, Hallila HO, Haaja JK, Koljonen VS, Leikola JP, Hukki JJ, Paulasto-Kröckel MM. Mesh-based method for measuring intracranial volume in patients with craniosynostosis. Int J Comput Assist Radiol Surg 2013; 8:703-9. [PMID: 23443983 DOI: 10.1007/s11548-013-0822-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE Craniosynostosis may lead to reduced intracranial volume (ICV) and disturb normal brain growth and development. Thus, ICV is an important parameter with respect to the surgical outcome. Current methods for ICV determination from computed tomography (CT) images have drawbacks. The aim of this study was to investigate the performance of the novel mesh-based method (MBM) for ICV determination with craniosynostosis patients. METHODS Twenty-two patients operated on for scaphocephaly were included in this study. ICVs from preoperative, one-week postoperative, and one-year postoperative CT images were measured with MBM. The level of agreement with the manual segmentation method (MSM) was determined for the measurements of preoperative and one-year postoperative datasets. Repeatability was determined with re-measurements of six datasets. Measurement time was recorded for MBM. RESULTS Mean [Formula: see text] preoperative ICV values were 895.0 [Formula: see text] 153.1 [Formula: see text] and 896.4 [Formula: see text] 147.2 [Formula: see text] as measured with MBM and MSM, respectively. Corresponding one-year postoperative values were 1,238.3 [Formula: see text] 118.7 [Formula: see text] and 1,250.1 [Formula: see text] 117.5 [Formula: see text]. The MBM allowed ICV determination from one-week postoperative datasets. Measurement time with MBM was 4 CONCLUSIONS: MBM is an efficient method for determining the ICV of craniosynostosis patients, allowing the measurement of skulls with bony defects. The repeatability and short measurement time of MBM are attributable to the user interference and assessment of the measurement process.
Collapse
Affiliation(s)
- Antti G Ritvanen
- Department of Electronics, School of Electrical Engineering, Aalto University, Otakaari 7B, 02150 , Espoo, Finland,
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Abstract
Nonsyndromic craniosynostosis is more commonly encountered than syndromic cases in pediatric craniofacial surgery. Affected children display characteristic phenotypes according to the suture or sutures involved. Restricted normal growth of the skull can lead to increased intracranial pressure and changes in brain morphology, which in turn may contribute to neurocognitive deficiency. Management has primarily focused on surgical correction of fused sutures prior to 12 months of age to optimize correction of the deformity and to ameliorate the effects of increased intracranial pressure. However, emphasis has recently shifted to better understanding the pathogenesis of neurocognitive impairment observed in these children, along with genetic mutations that contribute to premature suture fusion. Such understanding will provide opportunities for earlier and more specific neurocognitive interventions and for the development of targeted genetic therapy to prevent pathologic suture fusion. The authors review the common types of nonsyndromic craniosynostosis and the epidemiological, genetic, and neurodevelopmental details that are currently known from the literature. In addition, they present the rationale for surgical correction, offer suggestions for timing of intervention, and present some nuances of techniques that they find important in producing consistent results.
Collapse
Affiliation(s)
- Rebecca M. Garza
- Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, California
| | - Rohit K. Khosla
- Division of Plastic and Reconstructive Surgery, Stanford University, Stanford, California
| |
Collapse
|