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Test-retest validation of a cranial deformity index in unilateral coronal craniosynostosis
Emilie Robertson1,2,3, Peter Kwan1, Gorman Louie1
1Division of Plastic and Reconstructive Surgery, University of Alberta, Edmonton, Canada.
Insights
A new cranial deformity index quantifies unilateral coronal craniosynostosis (UCS) abnormalities objectively. This user-friendly tool aids surgical teams in assessing outcomes and improving patient consultations.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Medical Imaging Analysis
Background:
- Unilateral coronal craniosynostosis (UCS) causes significant infant head and facial deformities.
- Current methods for assessing UCS deformity are often subjective or cumbersome.
- Lack of standardized outcome measures hinders evaluation of surgical treatments for UCS.
Purpose of the Study:
- To develop an accessible and user-friendly cranial deformity index for quantifying UCS.
- To provide objective surface distance measurements for assessing frontal bone abnormalities.
- To establish a reliable tool for evaluating surgical outcomes in UCS patients.
Main Methods:
- Developed a cranial deformity index based on Euclidean distance between deformed and reference skulls.
- Defined the index by the point of largest deviation in frontal bone morphology.
- Assessed index reproducibility using test-retest reliability (Intraclass Correlation Coefficient - ICC).
Main Results:
- The cranial deformity index effectively quantifies frontal bone abnormalities in UCS.
- The index successfully measured post-operative changes in a single UCS case.
- Demonstrated high reproducibility of the index (ICC = 0.93).
Conclusions:
- A user-friendly, objective cranial deformity index can aid surgical teams in managing UCS.
- This tool offers objective data for surgical outcome assessment and patient consultation.
- Open-source implementation of this index may enhance its clinical utility.
Abstract:
Unilateral coronal craniosynostosis (UCS) affects many infants resulting in abnormalities affecting the forehead and orbits. As a result, the deformity caused by UCS is very noticeable and there are several surgical treatment options available to normalize the head shape. However, there is a lack of consistently used outcome measures, resulting in difficulty assessing surgical outcomes and on-going debate over optimal treatments. Current techniques to quantify deformity in UCS are cumbersome, provide limited information, or are based on subjective assessments. In this study, a cranial deformity index was developed to quantify abnormality at the frontal bones for UCS that is accessible, user-friendly, and generates objective surface distance measurements. The cranial deformity index is defined as the Euclidean distance at the point of the largest deviation between the deformed skull compared to a reference skull. In addition, the index was successfully used to quantify post-operative changes in a single case of UCS that underwent corrective surgery. The reproducibility of the index was assessed using test-retest reliability and was demonstrated to be highly reproducible (ICC = 0.93). A user-friendly measurement index that is based on open-source software may be a valuable tool for surgical teams. In addition, this information can augment the consultation experience for patients and their families.
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