Clinical Classification of Infant Nonsynostotic Cranial Deformity

Wilbrand, Jan-Falco; Schmidtberg, Kerstin; Bierther, Uta; Streckbein, Philipp; Pons-Kuehnemann, Joern; Christophis, P.; Hahn, Andreas; Schaaf, Helmut; Howaldt, Hans‐Peter

doi:10.1016/j.jpeds.2012.05.023

Cited by 83 publications

(76 citation statements)

References 21 publications

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“…Three groups were identified (positional plagiocephaly [abnormal cranial vault asymmetry index], positional brachycephaly [abnormal cranial index], and combined) and categorized by severity (mild, moderate, and severe). 16 Loveday and de Chalain 17 also described significant plagiocephaly as cranial vault assymetry greater than 3.5% and normal cranial index as between 75% to 85%. 17 Moss proposed defining severe DP as CVA greater than 12 mm.…”

Section: Discussionmentioning

confidence: 97%

Argenta Clinical Classification of Deformational Plagiocephaly

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Kesty

Krebs

et al. 2015

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 97%

Argenta Clinical Classification of Deformational Plagiocephaly

Branch

Kesty

Krebs

et al. 2015

Journal of Craniofacial Surgery

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“…Anthropometric indices have been successfully applied to assessing cranial deformity in Down syndrome, positional plagiocephaly, and brachycephaly. 6,21,22 Indeed, previous studies have demonstrated that anthropometric indices can be successfully used in the assessment of metopic synostosis. Kolar and Salter 10 assessed 24 anthropometric measurements in patients with trigonocephaly and calculated 11 cranial indices.…”

Section: Discussionmentioning

confidence: 99%

“…8 The use of anthropometric cranial measurements has improved the precision and reliability of the assessment of other cranial deformities such as positional plagiocephaly, scaphocephaly, and brachycephaly. 21,22 The objective of this study was to describe the metopic index (MI), a simple anthropometric cranial measurement that can be obtained both from CT scans and from palpable cranial landmarks, as a rapid tool for evaluating patients with metopic synostosis in both pre-and postoperative settings.…”

mentioning

confidence: 99%

The metopic index: an anthropometric index for the quantitative assessment of trigonocephaly from metopic synostosis

Wang¹,

Dorafshar

Liu³

et al. 2016

PED

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OBJECTIVE Because the metopic suture normally fuses during infancy, there are varying degrees of severity in head shape abnormalities associated with premature fusion. A method for the objective and reproducible assessment of metopic synostosis is needed to guide management, as current methods are limited by their reliance on aesthetic markers. The object of this study was to describe the metopic index (MI), a simple anthropometric cranial measurement. The measurements can be obtained from CT scans and, more importantly, from palpable cranial landmarks, and the index provides a rapid tool for evaluating patients in both pre- and postoperative settings. METHODS High-resolution head CT scans obtained in 69 patients (age range 0–24 months) diagnosed with metopic craniosynostosis were retrospectively reviewed. Preoperative 3D reconstructions were available in 15 cases, and these were compared with 3D reconstructions of 324 CT scans obtained in a control group of 316 infants (age range 0–24 months) who did not have any condition that might affect head size or shape and also in a subset of this group, comprising 112 patients precisely matched to the craniosynostosis patients with respect to age and sex. Postoperative scans were available and reviewed in 9 of the craniosynostosis patients at a mean time of 7.1 months after surgical repair. 3D reconstructions of these scans were matched with controls based upon age and sex. RESULTS The mean preoperative MI for patients with trigonocephaly was 0.48 (SD 0.05), significantly lower than the mean values of 0.57 (SD 0.04) calculated on the basis of all 324 scans obtained in controls (p < 0.001) and 0.58 (SD 0.04) for the subset of 112 age- and sex-matched controls (p < 0.001). For 7 patients with both pre- and postoperative CT scans available for evaluation, the mean postoperative MI was 0.55 (SD 0.03), significantly greater than their preoperative MIs (mean 0.48 [SD 0.04], p = 0.001) and comparable to the mean MI of the controls (p = 0.30). In 4 patients, clinically obtained postoperative MIs by caliper measurement were comparable to measurements derived from CT (p = 0.141). CONCLUSIONS The MI is a useful measurement of the severity of trigonocephaly in patients with metopic synostosis. This simple quantitative assessment can potentially be used in the clinical setting to guide preoperative evaluation, surgical repair, and postoperative degree of correction.

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“…The cranial index (CI) was calculated and included in the analysis because dolichocephaly, which is defined by a CI < 76%, is often related to prematurity at birth . The CI is usually defined by the ratio of the fronto‐occipital diameter (FOD) and the biparietal diameter (BPD) . In this study, we used a minor diameter to major diameter ratio (MRI‐based CI or mCI), measured by MRI, with the anterior‐ and posterior‐commissure lines aligned in the Talairach space (Fig ) because the FOD and the BPD were not available for all infants.…”

Section: Methodsmentioning

confidence: 99%