Quantification of Bilateral Coronal Synostosis: Anterior Brachycephaly

Abstract

Objectives: Very few studies focus on the quantification of severity of synostotic anterior brachycephaly. Aim of this study is to implement Utrecht Cranial Shape Quantifier (UCSQ) in brachycephaly patients to objectively quantify severity for both clinical and research purposes. Design: Retrospective study. Setting: Primary craniofacial center. Patients and Participants: Fifteen preoperative patients with bilateral coronal craniosynostosis (age <1.5 years). Intervention: Utrecht Cranial Shape Quantifier was used to quantify severity using the variables: width of frontal peak ratio, difference forehead peak and occiput peak, and width between sides of the head. Main Outcome Measure(s): The UCSQ variables were combined and related to Argenta clinical classification and cephalic index (CI) using 1-way analysis of variance (ANOVA). All parameters were derived from computed tomography scans. Results: Statistically significant differences were found between group means of UCSQ in the 3 categories of Argenta (ANOVA; F(2,12) = 22.461; P < .01). Tukey post hoc test showed a significant difference between Argenta types 1 and 2, types 1 and 3, and types 2 and 3 (all P < .01). Statistically significant differences were found between traditional CI and Argenta types ( F(2,12) = 4.956; P = .03). Tukey post hoc test showed significantly difference between Argenta type 1 and 3 ( P = .02). No differences were found between other types. Low correlation was found between UCSQ and CI ( r = 0.47). Conclusions: Utrecht Cranial Shape Quantifier objectively captures and quantifies the shape of synostotic brachycephaly, and we therefore developed a suitable method to put severity of synostotic (anterior) brachycephaly into numbers.

Incorporation of a biparietal narrowing metric to improve the ability of machine learning models to detect sagittal craniosynostosis with 2D photographs

“…Last, the optimum cutoff value identified for CI in this cohort was much higher than the value most specialists would use in clinical practice, as many use an abnormal CI cutoff of 71%-75%. [33][34][35] This cutoff value finding in the present study may have resulted from inclusion of unbalanced craniofacial classes due to the aforementioned biased patient selection in the data set. A larger, balanced patient cohort could help resolve this incongruity with prior literature.…”

UCSQ Method Applied on 3D Photogrammetry: Non-Invasive Objective Differentiation Between Synostotic and Positional Plagiocephaly

“…Additionally, a decisive flowchart for diagnosing the different subgroups of craniosynostosis was proposed. [17][18][19][20] As mentioned before, UCSQ is currently performed on CT scans, however, due to the use of external landmarks and the external skull outline, UCSQ has the advantage of potential applicability to all 3D-surface rendering techniques. A promising 3D-surface method is 3D stereophotogrammetry (3D photogrammetry).…”

Classification of Skull Shape Deformities Related to Craniosynostosis on 3D Photogrammetry

“…UCSQ has provided a method to diagnose the patients based on selected variables extracted from these curves. These variables were found to be suitable for quantification purposes for each of the previously mentioned subtypes of craniosynostosis 14–17. UCSQ can be used to identify associations between severity of skull the skull deformity and clinical features 18,19…”