Quantifying the effect of corrective surgery for trigonocephaly: A non-invasive, non-ionizing method using
Naiara Rodriguez-Florez1, Özge K Göktekin1, Jan L Bruse2
1UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Summary
Fronto-orbital remodelling (FOR) successfully corrects metopic synostosis by improving forehead volume. However, 3D analysis shows this surgical technique may overcorrect forehead rounding compared to controls.
Area of Science:
- Craniofacial Surgery
- Medical Imaging
- Biomechanical Engineering
Background:
- Metopic synostosis causes trigonocephaly, a forehead deformity.
- Fronto-orbital remodelling (FOR) is a surgical technique to correct this condition.
- Quantitative assessment of aesthetic outcomes is crucial for evaluating surgical success.
Purpose of the Study:
- To quantitatively assess the aesthetic outcomes of fronto-orbital remodelling (FOR) in patients with metopic synostosis.
- To compare 3D forehead shapes of patients pre- and post-FOR with non-craniosynostotic controls.
- To evaluate the effectiveness of FOR in correcting trigonocephaly and bitemporal narrowing.
Main Methods:
- Recruitment of 10 single-suture metopic patients and 15 age-matched controls.
- Acquisition of 3D forehead scans using a handheld camera.
- Analysis using 3D imaging software, cephalometric measurements, statistical shape modelling, and principal component analysis (PCA).
Main Results:
- FOR significantly increased forehead volume and improved trigonocephaly (p < 0.001).
- 3D mean head shape analysis visually and numerically confirmed improvements post-FOR.
- Post-operative scans revealed flatter foreheads compared to controls (p < 0.001), indicating overcorrection of rounding.
Conclusions:
- 3D scanning and statistical shape modelling provide effective tools for comparing forehead aesthetics.
- The FOR technique successfully corrects bitemporal narrowing in metopic synostosis.
- The study highlights a tendency for FOR to overcorrect forehead rounding.
