Methods to quantify soft tissue-based cranial growth and treatment outcomes in children: a systematic review
Sander Brons1, Machteld E van Beusichem1, Ewald M Bronkhorst2
1Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Insights
Reliable methods exist for measuring children's head growth. Direct anthropometry is best for routine checks, while stereophotogrammetry offers versatile 3D analysis for assessing cranial dimensions.
Area of Science:
- Pediatric medicine
- Craniofacial development
- Medical imaging
Background:
- Longitudinal assessment of pediatric cranial dimensions is crucial for monitoring normal growth, identifying deviations, and evaluating treatment effectiveness.
- Accurate measurement of head growth in children informs clinical decisions and developmental assessments.
Purpose of the Study:
- To review soft tissue-based methods for quantitative, longitudinal assessment of cranial dimensions in children up to age 6.
- To evaluate the reliability of these methods in high-quality studies.
Main Methods:
- Comprehensive literature search across major databases (PubMed, EMBASE, etc.) and manual checks.
- Inclusion of primary studies on pediatric facial growth and treatment outcomes in children under 6 years.
- Independent data extraction and quality assessment, focusing on measurement error and correlation coefficients for reliability.
Main Results:
- 165 studies analyzed, categorizing methods into head circumference anthropometry, direct anthropometry, and 2D/3D imaging (laser scanning, stereophotogrammetry).
- Measurement errors generally remained below 2 mm, with very good correlation coefficients indicating high reliability.
- Stereophotogrammetry demonstrated versatility for detailed cranial shape and dimension analysis.
Conclusions:
- Multiple methods for measuring pediatric cranial dimensions are reliable for clinical use.
- Direct anthropometry is recommended for routine linear cranial measurements in children up to age 6.
- Stereophotogrammetry is the most adaptable method for comprehensive longitudinal assessment of cranial morphology in children.
Context:
Longitudinal assessment of cranial dimensions of growing children provides healthcare professionals with information about normal and deviating growth as well as treatment outcome.
Objective:
To give an overview of soft tissue-based methods for quantitative longitudinal assessment of cranial dimensions in children until age 6 years and to assess the reliability of these methods in studies with good methodological quality.
Data Source:
PubMed, EMBASE, Cochrane Library, Web of Science, Scopus, and CINAHL were searched. A manual search was performed to check for additional relevant studies.
Study Selection:
Primary publications on facial growth and treatment outcomes in children younger than age 6 years were included.
Data Extraction:
Independent data extraction was performed by two observers. A quality assessment instrument was used to determine methodological quality. Methods used in studies with good methodological quality were assessed for reliability expressed as the magnitude of the measurement error and the correlation coefficient between repeated measurements.
Results:
In total, 165 studies were included, forming three groups of methods: head circumference anthropometry, direct anthropometry, and 2D photography and 3D imaging techniques (surface laser scanning and stereophotogrammetry). In general, the measurement error was below 2 mm, and correlation coefficients were very good.
Conclusion:
Various methods for measuring cranial dimensions have shown to be reliable. Stereophotogrammetry is the most versatile method for quantitative longitudinal assessment of cranial dimensions and shapes in children. However, direct anthropometry continues to be the best method for routine clinical assessments of linear cranial dimensions in growing children until age 6 years.
