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Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Intracranial volume in 15 children with bilateral coronal craniosynostosis
Robert C J Tovetjärn1, Giovanni Maltese1, Emma Wikberg1
1Craniofacial Unit, Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden; and Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Insights
Children with bilateral coronal craniosynostosis (BCS) undergoing spring-assisted cranioplasty maintained normal intracranial volume (ICV) growth. This surgical approach appears effective in preserving age-related ICV development up to three years of age.
Area of Science:
- Pediatric Neurosurgery
- Craniofacial Surgery
- Developmental Biology
Background:
- Intracranial volume (ICV) growth patterns in patients with bilateral coronal craniosynostosis (BCS) are not well-established.
- Evaluating the long-term effects of surgical interventions on ICV is crucial for understanding developmental outcomes in children with BCS.
Purpose of the Study:
- To assess and compare intracranial volumes (ICVs) in pediatric patients who underwent surgical correction for bilateral coronal craniosynostosis (BCS).
Main Methods:
- A cohort of BCS patients treated with spring-assisted cranioplasty were analyzed using high-resolution computed tomography (CT) scans.
- Intracranial volumes were measured using a specialized MATLAB-based program.
- Patient ICVs were statistically compared against an age- and gender-matched control group of healthy children.
Main Results:
- The study included 15 BCS patients (13 syndromic, 2 non-syndromic) with 43 CT scans.
- Mean preoperative ICV at 5 months was 887 mL, increasing to 1369 mL at 3 years.
- Follow-up ICVs in BCS patients were comparable to control group means (854 mL at 5 months, 1358 mL at 3 years), with no statistically significant differences (P > 0.05).
Conclusions:
- Spring-assisted cranioplasty in BCS patients allows for maintenance of age-appropriate intracranial volume.
- The surgical technique appears to support normal ICV development trajectory up to three years of age when compared to healthy peers.
Background:
Intracranial volume (ICV) growth in patients with bilateral coronal craniosynostosis (BCS) is not well described. It is therefore important to evaluate the consequences of cranial surgery in children with this condition. The aim of the present study was to evaluate ICVs in patients operated on for BCS.
Methods:
A consecutive series of patients with BCS were operated on using spring-assisted cranioplasty, with computed tomography scans in 0.6-mm slices, were included. A MATLAB-based computer program capable of measuring ICV was used. Patients were compared with an age- and gender-matched control group of healthy children. Student's t test was used for statistical analysis.
Results:
Fifteen patients (7 girls and 8 boys) with 43 computed tomography scans were identified. The diagnoses were 13 syndromic BCS (3 Apert, 1 Crouzon, 6 Muenke, and 3 Saethre-Chotzen) and 2 nonsyndromic BCS. The mean preoperative volume at the age of 5 months (n = 15) was 887 mL (range, 687-1082). Mean volume at follow-up at the age of 3 years (n = 13) was 1369 mL (range, 1196-1616). In comparison, the mean ICVs for controls at the ages of 5 months (n = 30) and 3 years (n = 26) were 854 mL and 1358 mL, respectively. The differences were not statistically significant (P > 0.05).
Conclusions:
Patients with BCS were operated on with spring-assisted cranioplasty seem to maintain their age-related ICV at 3 years of age when compared to normal children.
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