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Photogrammetric evaluation of corrective surgery for trigonocephaly
R Kuehle1, N Ewerbeck1, T Rückschloß1
1Department of Oral and Maxillofacial Surgery, University of Heidelberg, Heidelberg, Germany.
Insights
Fronto-orbital remodelling (FOR) effectively corrects head shape deformities in male infants with metopic synostosis. Three-dimensional (3D) photography confirms surgical success, offering a radiation-free diagnostic alternative.
Area of Science:
- Craniofacial Surgery
- Pediatric Neurosurgery
- Medical Imaging
Background:
- Metopic synostosis is a premature fusion of the metopic suture, leading to trigonocephaly (triangular head shape) in infants.
- Fronto-orbital remodelling (FOR) is a surgical technique used to correct these deformities.
- Accurate assessment of surgical outcomes is crucial for evaluating treatment efficacy.
Purpose of the Study:
- To evaluate the effectiveness of fronto-orbital remodelling (FOR) in correcting head shape deformities in male infants with metopic synostosis.
- To compare postoperative head shape measurements with a healthy control group at 14 days and 1 year post-surgery.
- To assess the utility of three-dimensional (3D) photogrammetry as a diagnostic tool.
Main Methods:
- A cohort of 57 male infants with metopic synostosis underwent standardized FOR.
- Three-dimensional (3D) photography was used to capture head shapes preoperatively, 14 days postoperatively, and at 1-year follow-up.
- Measurements including intracranial volume, frontal angle, nasofrontal angle, interfrontoparietal-interparietal ratio, and inter-orbital distances were compared to age-matched controls.
Main Results:
- Preoperatively, patients exhibited reduced intracranial volume, frontal angle, interfrontoparietal-interparietal ratio, and orbital distances compared to controls.
- Postoperative measurements at 14 days and 1 year showed no significant differences from the control group, indicating successful correction.
- 3D photogrammetry proved effective in assessing outcomes and offers a radiation-free alternative to CT scans.
Conclusions:
- Standardized FOR effectively corrects head shape abnormalities in male infants with metopic synostosis.
- 3D photogrammetry is a valuable tool for diagnosing metopic synostosis and monitoring surgical outcomes, minimizing radiation exposure.
- Surgical goals should focus on achieving significant volume expansion and deformity correction.
Abstract:
The aim of this study was to capture preoperative, postoperative, and follow-up head shapes of male trigonocephaly patients who underwent fronto-orbital remodelling (FOR), using three-dimensional (3D) photography. Fifty-seven male infants with metopic synostosis operated on using standardized FOR during a 5-year period were included. All measurements were compared with those of an age-matched healthy control cohort (n = 253 for early postoperative comparison, n = 43 for the 1-year follow-up comparison) to determine the effect of FOR at 14 days and at 1 year post-surgery. Intracranial volume, frontal angle, nasofrontal angle, interfrontoparietal-interparietal ratio, and inter-orbital distances were measured 1 day preoperatively, 14 days and 1 year postoperatively. Mean age at surgery was 9.7 ± 1.1 months. Prior to surgery, boys with metopic synostosis showed a reduced intracranial volume (-7.0%, P < 0.001), frontal angle (-10.2%, P < 0.001), interfrontoparietal-interparietal ratio (-4.9%, P < 0.01), and orbital distances (-6.5%, P < 0.001) compared to the reference group, but values did not differ significantly from the specific control group after surgery (all P> 0.05). This was consistent by the time of the follow-up examination. Corrective surgery should therefore aim to achieve volume expansion and correction of the deformity. Furthermore, 3D photogrammetry provides a valuable alternative to computed tomography scans in the diagnosis of metopic synostosis, significantly reducing the amount of radiation exposure to the brain.
