[Radiometric study of postoperative development of skull shape and cranial volume in children with craniosynostoses]

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Medical Imaging

Background:

• Computed tomography (CT) is crucial for preoperative evaluation of craniosynostosis but postoperative monitoring is limited due to anesthesia and radiation.
• Accurate metric examination of cranial growth in these patients is challenging.
• A need exists for a non-invasive, repeatable method for assessing skull shape and intracranial volume post-surgery.

Purpose of the Study:

• To develop and validate an alternative to CT for assessing skull shape and intracranial volume in pediatric craniosynostosis.
• To evaluate the effectiveness of a standardized bilateral frontoorbital advancement surgical technique.
• To establish a safe, exposure-reduced method for routine preoperative and postoperative analysis.

Main Methods:

• Conventional pre- and postoperative skull roentgenograms were utilized in 15 pediatric patients (7 trigonocephalies, 4 plagiocephalies, 4 syndromal craniosynostoses).
• A modified craniometric analysis (Ebel and Schmid methods) was performed to assess skull length, height, and breadth.
• Intracranial volume and skull shape were analyzed, with results validated against published data.

Main Results:

• Skull shape and intracranial volume demonstrated positive development, varying with the specific craniosynostosis type.
• Standardized bilateral frontoorbital advancement was confirmed as an effective surgical intervention.
• The developed roentgenogram-based analysis method proved easy, safe, and effective for routine use.

Conclusions:

• Skull roentgenogram analysis offers a viable, low-exposure alternative to CT for craniosynostosis assessment.
• This method facilitates regular preoperative diagnostics and postoperative control of cranial growth.
• The findings support the routine implementation of this craniometric analysis in managing pediatric craniosynostosis.