Outcomes of Surgical Management of Metopic Synostosis : A Retrospective Study of 18 Cases

Elhawary, Mohamed E.; Adawi, Mohammed; Gabr, Mohamed

doi:10.3340/jkns.2021.0034

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…31,32 A major limitation of implementing standardized protocols is the lack of objective quantification of severity. The Whitaker classification has been the accepted standard for aesthetic outcomes reporting in craniosynostosis research, [33][34][35][36] but has been shown to have low interrater reliability and cannot predict the need for future interventions. 37 Most often, the decision is subjective and relies on surgical experience.…”

Section: Discussionmentioning

confidence: 99%

CranioRate TM: An Image-Based, Deep-Phenotyping Analysis Toolset and Online Clinician Interface for Metopic Craniosynostosis

Beiriger

Tao

Bruce

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: The diagnosis and management of metopic craniosynostosis involve subjective decision-making at the point of care. The purpose of this work was to describe a quantitative severity metric and point-of-care user interface to aid clinicians in the management of metopic craniosynostosis and to provide a platform for future research through deep phenotyping. Methods: Two machine-learning algorithms were developed that quantify the severity of craniosynostosis—a supervised model specific to metopic craniosynostosis [Metopic Severity Score (MSS)] and an unsupervised model used for cranial morphology in general [Cranial Morphology Deviation (CMD)]. Computed tomographic (CT) images from multiple institutions were compiled to establish the spectrum of severity, and a point-of-care tool was developed and validated. Results: Over the study period (2019 to 2021), 254 patients with metopic craniosynostosis and 92 control patients who underwent CT scanning between the ages of 6 and 18 months were included. CT scans were processed using an unsupervised machine-learning based dysmorphology quantification tool, CranioRate. The average MSS was 0.0 ± 1.0 for normal controls and 4.9 ± 2.3 (P < 0.001) for those with metopic synostosis. The average CMD was 85.2 ± 19.2 for normal controls and 189.9 ± 43.4 (P < 0.001) for those with metopic synostosis. A point-of-care user interface (craniorate.org) has processed 46 CT images from 10 institutions. Conclusions: The resulting quantification of severity using MSS and CMD has shown an improved capacity, relative to conventional measures, to automatically classify normal controls versus patients with metopic synostosis. The authors have mathematically described, in an objective and quantifiable manner, the distribution of phenotypes in metopic craniosynostosis.

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Section: Discussionmentioning

confidence: 99%

CranioRate TM: An Image-Based, Deep-Phenotyping Analysis Toolset and Online Clinician Interface for Metopic Craniosynostosis

Beiriger

Tao

Bruce

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Endoscopic surgery for craniosynostosis: A systematic review and single-arm meta analysis

Porto Junior,

Meira,

da Cunha

et al. 2024

Clinical Neurology and Neurosurgery

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Insights into craniosynostosis management in low- and middle-income countries: A narrative review of outcomes, shortcomings and paediatric neurosurgery capacity

Wireko,

Ahluwalia,

Ali

et al. 2024

SAGE Open Medicine

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Craniosynostosis, marked by premature cranial suture fusion, necessitates prompt intervention to avert developmental, neurological, and aesthetic issues. While high-income countries have advanced in managing this condition, low- and middle-income countries grapple with substantial healthcare access disparities. This narrative review explores current craniosynostosis management in low- and middle-income countries. The review focused on studies published between 2008 and 2023. The focus was neurosurgical outcomes, and the search utilised databases like PubMed, EMBASE, Google Scholar, the Cochrane Library and Scopus, incorporating specific keywords and phrases. An in-depth analysis of 21 included studies reveals noteworthy positive outcomes, including low mortality, successful corrections and sustained efficacy. These advancements stem from enhanced pre-operative strategies, surgical techniques and postoperative care. Nonetheless, challenges persist, encompassing complications, mortality, reoperations, and treatment disparities, particularly in low- and middle-income countries constrained by financial and expertise limitations. The enhancement of clinical practice and the formulation of effective policies in the future entail several key strategies. These include the reinforcement of specialised healthcare infrastructure and diagnostic capabilities, the ongoing training and retention of neurosurgeons, the improvement of funding mechanisms, and the promotion of equitable access. Additionally, a crucial focus is placed on fortifying paediatric neurosurgical care in low- and middle-income countries. The recommendations underscore the importance of collaborative initiatives, the development of specialised healthcare infrastructure, and the implementation of strategic policies to not only advance pediatric neurosurgical care but also to address existing gaps in management.

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Outcomes of Surgical Management of Metopic Synostosis : A Retrospective Study of 18 Cases

Cited by 3 publications

References 32 publications

CranioRate TM: An Image-Based, Deep-Phenotyping Analysis Toolset and Online Clinician Interface for Metopic Craniosynostosis

CranioRate TM: An Image-Based, Deep-Phenotyping Analysis Toolset and Online Clinician Interface for Metopic Craniosynostosis

Endoscopic surgery for craniosynostosis: A systematic review and single-arm meta analysis

Insights into craniosynostosis management in low- and middle-income countries: A narrative review of outcomes, shortcomings and paediatric neurosurgery capacity

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