Sphenotemporal and Fronto-Orbital Dysmorphology in Unilateral Coronal Synostosis Using Geometric Morphometric Curve-Based Analysis

Abstract

Background: Geometric morphometric analysis with Procrustes superimposition is a commonly used method to characterize and study complex dysmorphology. The present study employs an advanced Procrustes-based approach to studying craniofacial dysmorphology in unilateral coronal synostosis and quantitatively describe bony patterns in this disorder, in order to better understand the associated fronto-orbital and sphenotemporal deformities. Methods: Forty-one unilateral coronal synostosis (UCS) patients and 41 age-and sex-matched controls underwent high-resolution computed tomography imaging. Thirty-one anatomical landmarks were labeled on each imaging set. Landmarks were used to calculate angle, lengths, and define fronto-orbital and sphenotemporal anatomical curves. A validated geometric morphometric workflow was used to perform a Procrustes superimposition to register landmarks into a common space and perform a principal components analysis. Results: Supraorbital bar curvature was significantly increased ipsilateral to the fused suture and decreased contralateral, P < 0.0001 for both sides. The sagittal sphenotemporal curve also showed ipsilateral increase in curvature (P < 0.0001) but there was no effect on the contralateral side (P > 0.05). Conclusions: Geometric morphometric analysis revealed significant dysmorphology between UCS patients and controls.These results suggest bilateral changes in fronto-orbital curvature and ipsilateral changes in sagittal sphenotemporal curvature, which may be useful in further characterizing the dynamic craniofacial changes in UCS.

Developing a Craniofacial Soft Tissue Anthropomorphic Database with Magnetic Resonance Imaging and Unbiased Diffeomorphic Registration

“…31 Several strategies have emerged to ameliorate subjectivity in the appraisal of craniofacial dysmorphology and postoperative outcomes. 8 Such techniques include artificial intelligence and convolutional neural networks, 32 crowdsourcing, 33,34 geometric morphometric analysis, 35 novel low-risk diagnostic strategies, 36 eye-tracking, 37 two-dimensional vector analysis, 9 and threedimensional stereophotogrammetry. 38 Each approach has unique benefits and drawbacks; in general, accessible techniques tend to be more subjective than complex or technical approaches, which tend to afford higher degrees of objectivity.…”

Choosing a Multidisciplinary Cleft and Craniofacial Team: Medical, Surgical, and Social Considerations

“…These programs tend to attract a depth and breadth of pathologies which prepares teams to tackle surgical problems with unique approaches. 36 Other benefits of academic surgical environments include research efforts that may offer minimally invasive and low-risk diagnostic strategy, [37][38][39] advanced image handling techniques [40][41][42] and opportunity to participate in longitudinal studies to contribute to cleft and craniofacial surgical knowledge. 43,44…”

Craniofacial Dysmorphology in Infants With Non-Syndromic Unilateral Coronal Craniosynostosis

“…4 Specifically, although primary morphologic changes occur at the site of bony defect, there are broader compensatory consequences seen through more distant regions of the calvarial and craniofacial skeleton. [6][7][8] These deformities require surgery, most commonly fronto-orbital advancement (FOA), to correct the shape of the skull and prevent neurologic and craniofacial sequelae. If left without surgical release during the period of brain growth, many patients will develop craniofacial abnormalities that cannot be corrected in the future.…”