Objectification of cranial vault correction for craniosynostosis by three-dimensional photography

Abstract

Purpose: Correction of craniosynostosis is necessary in predominant cases. Surgical planning usually requires a preoperative CT to estimate the bony and intracerebral structures. A postoperative CT scan would involve a significant dose of radiation, which carries an elevated risk of malignant tumor development in later life. This study was performed to demonstrate the quality of three-dimensional (3D) photogrammetry when objectifying perioperative changes in craniofacial surgery.

Patients and methods: Twenty-eight patients with different premature craniosynostoses were analyzed photogrammetrically before and after surgical correction. 3D changes in cranial distances, symmetry and volumes were evaluated. A statistical covariance analysis excluded changes in cranial shape caused by physiological head growth.

Results: The Cephalic Index in Scaphocephaly changed from 75.1% to a median value of 77.4%. The anterior symmetry ratio for coronal synostoses improved from 0.943 to 0.949 (a value of 1.0 represents perfect symmetry). The posterior symmetry ratio improved from 0.733 to 0.808 postoperatively in one single lambdoidal synostosis. In trigonocephaly, the median anterior skull volume rose from 528 to 601 ml.

Conclusions: 3D photogrammetry has great potential to track and objectify the clinical course of surgical correction of craniosynostoses. Craniofacial changes become highly reproducible and demonstrate clinical utility based on this technology.