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Paediatric skull growth models: A systematic review of applications to normal skulls and craniosynostoses
Maya Geoffroy1, Pierre-Marc François2, Roman Hossein Khonsari3
1Arts et Métiers Institute of Technology, Université Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, F-75013, Paris, France; Service de Chirurgie Maxillofaciale et Chirurgie Plastique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Faculté de Médecine, Université de Paris; 149 Rue de Sèvres, 75015 Paris, France; BONE 3D; 14 Rue Jean Antoine de Baïf, 75013 Paris, France.
Insights
This review analyzes cranial vault growth models for craniosynostosis, finding successful models integrate skull shape and suture bone formation for better surgical planning in infants.
Area of Science:
- Craniofacial development and modeling
- Pediatric neurosurgery
- Biomechanical engineering
Background:
- Craniosynostosis, affecting 1 in 2000 births, presents increasing incidence and can cause neurological issues and social stigma if untreated.
- Accurate understanding of cranial vault growth patterns is crucial for effective surgical planning and predicting outcomes in affected children.
- Current surgical approaches require robust models to address abnormal head shapes and restricted brain growth.
Purpose of the Study:
- To systematically review and analyze existing normal and pathological cranial vault growth models.
- To identify key features and limitations of current growth models used in craniosynostosis research.
- To inform the development of advanced surgical planning strategies for pediatric craniofacial anomalies.
Main Methods:
- Systematic literature review of full-text articles focusing on skull vault growth models in children under two years old.
- Analysis of identified models based on initial geometry, numerical methods, age determination, and validation processes.
- Categorization of models into descriptive (statistical, deformational) and comprehensive (finite element, diffusion) types.
Main Results:
- Fourteen articles describing 17 distinct cranial vault growth models were reviewed.
- Successful models identified in the literature combined analyses of cranial vault shape and suture bone formation.
- Comprehensive models, including finite element and diffusion models, were more prevalent than descriptive models.
Conclusions:
- Growth modeling is essential for assessing craniofacial architecture and developing customized treatments for young patients with craniosynostosis.
- Generalizing specific craniosynostosis models across all subtypes remains a significant technical challenge.
- Further research is needed to address the role of brain growth and age-related developmental stages in craniosynostosis models.
Introduction:
Craniosynostoses affect 1/2000 births and their incidence is currently increasing. Without surgery, craniosynostosis can lead to neurological issues due to restrained brain growth and social stigma due to abnormal head shapes. Understanding growth patterns is essential to develop surgical planning approaches and predict short- and long-term post-operative results. Here we provide a systematic review of normal and pathological cranial vault growth models.
Material And Methods:
The systematic review of the literature identified descriptive and comprehensive skull growth models with the following criteria: full text articles dedicated to the skull vault of children under 2 years of age, without focus on molecular and cellular mechanisms. Models were analysed based on initial geometry, numerical method, age determination method and validation process.
Results:
A total of 14 articles including 17 models was reviewed. Four descriptive models were assessed, including 3 models using statistical analyses and 1 based on deformational methods. Thirteen comprehensive models were assessed including 7 finite element models and 6 diffusion models. Results from the current literature showed that successful models combined analyses of cranial vault shape and suture bone formation.
Discussion:
Growth modelling is central when assessing craniofacial architecture in young patients and will be a key factor in the development of future customized treatment strategies. Recurrent technical difficulties were encountered by most authors when generalizing a specific craniosynostosis model to all types of craniosynostoses, when assessing the role of the brain and when attempting to relate the age with different stages of growth.
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