The Postoperative Morphometrics of Orbital and Maxillary Area for Craniosynostosis

One of the most characteristic features in premature craniosynostosis is fronto-orbital retrusion. The standardized surgical technique of fronto-orbital advancement (FOA) can treat this (some) deformity, such as bilateral coronal synostosis. The purpose of the study is to investigate an available method to assess the postoperative outcome of the craniofacial surgery.

From 2010 to 2015, 6 pediatric patients were taken the FOA in the Department of Burn and Plastic Surgery in the Children's Hospital of Nanjing Medical University. All the patients were performed the computed tomography (CT) scan preoperatively and postoperatively. The CT databases were processed by DICOM files into MIMICS 16.0 software, which were automatically calculated into orbital volume and orbital roof and base surface area. T-test was used to compare measured values before and after surgery. P < 0.05 was considered statistically significant.

The average preoperative orbital volume was 13930.70 mm, and the postoperative was 18578.67917 mm. After operation, the volume of orbital was significantly increased (P < 0.05). The mean area of the orbital roof surface was 753.989025 mm preoperatively, and the postoperative was 1122.074583 mm. The difference was statistically significant (P < 0.05). The average area of the orbital base (S2) was 334.94 ± 91.76 mm. After the FOA, the orbital base was 356.99 ± 114.21 mm. P(S2) = 0.6072 > 0.05, there was no significant statistical difference.

Fronto-orbital advancement can successfully improve morphological orbital deformities in children with premature craniosynostosis, but much less for maxillary. The computer-assisted technique can present a measurement of FOA preoperatively and postoperatively, which make the evaluation intuitive.