Early bone reformation after cranial vault remodelling for sagittal craniosynostosis: A retrospective 3D analysis

Sarut Chaisrisawadisuk; Kantapat Phakdeewisetkul; Kanin Sirichatchai; Sasima Tongsai; Elie Hammam; Vani Prasad; Mark H Moore

doi:10.1016/j.jcms.2023.04.003

Early bone reformation after cranial vault remodelling for sagittal craniosynostosis: A retrospective 3D analysis

J Craniomaxillofac Surg. 2023 Apr;51(4):230-237. doi: 10.1016/j.jcms.2023.04.003. Epub 2023 Apr 6.

Authors

Sarut Chaisrisawadisuk¹, Kantapat Phakdeewisetkul², Kanin Sirichatchai³, Sasima Tongsai⁴, Elie Hammam⁵, Vani Prasad⁶, Mark H Moore⁷

Affiliations

¹ Cleft and Craniofacial SA, Women's and Children's Hospital, North Adelaide, South Australia, Australia; Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
² Biomechanics Research Center, Meticuly Co. Ltd., Chulalongkorn University, Bangkok, Thailand; Advanced Materials Analysis Research Unit, Department of Metallurgical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
³ Biomechanics Research Center, Meticuly Co. Ltd., Chulalongkorn University, Bangkok, Thailand.
⁴ Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
⁵ Department of Neurosurgery, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
⁶ Cleft and Craniofacial SA, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
⁷ Cleft and Craniofacial SA, Women's and Children's Hospital, North Adelaide, South Australia, Australia. Electronic address: Mark.Moore@sa.gov.au.

PMID: 37045612
DOI: 10.1016/j.jcms.2023.04.003

Abstract

This study aims to measure postoperative bone reformation percentage, rates and patterns after cranial vault remodelling (CVR) in isolated non-syndromic sagittal craniosynostosis. Volumetric bone measurements were performed starting from the DICOM files of previously available postoperative CT scans. The 3D images were then resampled into the master box, and 'Skull 3D models' were derived. The percentage of bone reformation was investigated using automated 3D analysis software. The intra-rater reliability analysis revealed high reliability (Intraclass correlation coefficient = 0.99, p < 0.001). The median bone reformation volume and rate were 11.2 ml and 1.98 ml/week, respectively. The median percentage of bone reformation was 56.7% when the median postoperative CT timing was 6.1 weeks. As a statistic model, the linear plateau showed the highest Pseudo R² in both volume and percentage of bone reformation predicting patterns. By using the calculated model at 9 weeks postoperatively, the re-osteogenesis reaches 80% of the total cranial defect. After CVR, the early bone reformation pattern was demonstrated as a linear plateau model rather than logarithmic. This study gives a better understanding of the pattern and quantity of re-osteogenesis at cranial defects after CVR. The statistic model can facilitate healthcare practitioners to predict bone reformation and improve postoperative care protocol in sagittal craniosynostosis management.

Keywords: 3D analysis; Cranial; Craniofacial abnormalities; Craniosynostosis; Osteogenesis.

MeSH terms

Craniosynostoses* / diagnostic imaging
Craniosynostoses* / surgery
Humans
Infant
Reproducibility of Results
Retrospective Studies
Skull* / diagnostic imaging
Skull* / surgery
Tomography, X-Ray Computed