A Suture-specific Photo Score for Metopic Synostosis

Area of Science:

• Craniofacial Surgery
• Pediatric Neurosurgery
• Medical Imaging

Background:

• Head shape assessment is crucial for children with metopic synostosis, yet consensus is lacking.
• Existing functional outcome measures do not fully capture head shape severity.
• A standardized, reliable method for head shape assessment is needed for clinical practice and research.

Purpose of the Study:

• To develop a reproducible and reliable suture-specific photo score for metopic synostosis.
• To enable cross-center comparison of phenotypical severity and treatment outcomes.
• To provide an objective tool for evaluating the esthetic results of metopic synostosis treatment.

Main Methods:

• Retrospective study of preoperative and postoperative photos from nonsyndromic metopic synostosis patients (<18 years) across 6 expert centers.
• Development and interrater reliability testing of a photo score assessing forehead wedging, hypotelorism, temporal hollowing, biparietal widening, and overall phenotype.
• Statistical analysis using modified weighted Fleiss' kappa, intraclass correlation coefficients, and Spearman correlation.

Main Results:

• The developed metopic synostosis photo score includes 5 items rated on a 4-point scale.
• Moderate interrater reliability was found for individual items, with substantial agreement for summed scores.
• Correlation with overall phenotype was lowest for biparietal widening, but summed scores showed consensus on overall severity.

Conclusions:

• The developed photo score demonstrates substantial agreement on the overall severity of the metopic synostosis phenotype.
• This tool can facilitate standardized, cross-center phenotypical assessment and treatment evaluation.
• Further refinement may improve agreement on individual item assessments.