3-Dimensional Morphometric Outcomes After Endoscopic Strip Craniectomy for Unicoronal Synostosis

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery
• Medical Imaging

Background:

• Endoscopic strip craniectomy with postoperative helmeting (ESCH) is a less invasive alternative to fronto-orbital remodeling (FOR) for unicoronal synostosis.
• This pilot study evaluates objective morphologic outcomes of ESCH using 3D surface scans.

Purpose of the Study:

• To report objective methods and quantitative morphologic outcomes of endoscopically treated unicoronal synostosis.
• To compare morphologic outcomes of ESCH with controls and FOR patients.

Main Methods:

• Review of ophthalmological, neurodevelopmental, and helmet complication data.
• Quantitative morphologic analysis using Cranial Index, Cranial Vault Asymmetry Index, Anterior Symmetry Ratio (ASR), and Root Mean Square.
• Evaluation of 3D stereophotogrammetry scans at preoperative, 6-month, and final time points.

Main Results:

• No strabismus, major neurodevelopmental delay, or helmet complications were observed in ESCH cases.
• Significant improvement in most morphologic parameters by 6 months post-op, with continued change in ASR.
• ESCH demonstrated significant differences in ASR and Root Mean Square compared to FOR and control groups at final assessment.

Conclusions:

• ESCH for single unicoronal synostosis yields excellent clinical outcomes.
• Head morphology improvement is most pronounced within the first six months post-procedure.
• Residual asymmetry in frontal and temporal regions may persist despite overall head shape normalization.