The Characterisation of the Craniofacial Morphology of Infants Born With Zika Virus; Innovative Approach for Public Health Surveillance and Broad Clinical Applications

Abstract

Background: This study was carried out in response to the Zika virus epidemic, which constituted a public health emergency, and to the 2019 WHO calling for strengthened surveillance for the early detection of related microcephaly. The main aim of the study was to phenotype the craniofacial morphology of microcephaly using a novel approach and new measurements, and relate the characteristics to brain abnormalities in Zika-infected infants in Brazil to improve clinical surveillance.Methods: 3D images of the face and the cranial vault of 44 Zika-infected infants and matched healthy controls were captured using a 3D stereophotogrammetry system. The CT scans of the brain of the infected infants were analysed. Principal component analysis (PCA) was applied to characterise the craniofacial morphology. In addition to the head circumference (HC), a new measurement, head height (HH), was introduced to measure the cranial vault. The level of brain abnormality present in the CT scans was assessed; the severity of parenchymal volume loss and ventriculomegaly was quantified. Student's t-test and Spearman's Rho statistical test have been applied.Findings: The PCA identified a significant difference (p < 0.001) between the cranial vaults and the face of the Zika infants and that of the controls. Spearman's rank-order correlation coefficients show that the head height (HH) has a strong correlation (0.87 in Zika infants; 0.82 in controls) with the morphology of the cranial vaults, which are higher than the correlation with the routinely used head circumference (HC). Also, the head height (HH) has a moderate negative correlation (−0.48) with the brain abnormalities of parenchymal volume loss.Interpretation: It is discovered that the head height (HH) is the most sensitive and discriminatory measure of the severity of cranial deformity, which should be used for clinical surveillance of the Zika syndrome, evaluation of other craniofacial syndromes and assessment of various treatment modalities.

Microcephaly as a risk factor for dental alterations: A case‐control study

“…Its main causes include genetic defects of recessive autosomal inheritance and some genetic syndromes, as well as environmental causes related to congenital infections and maternal exposure to drugs, radiation, and toxic substances (Carod-Artal, 2016). The severity of microcephaly is directly related to the underlying neurological damage (Ayoub et al, 2021). The consequences of microcephaly depend on the degree of the underlying brain abnormalities and may result in moderate to severe developmental delays.…”

Assessment of Cranial Deformation Indices by Automatic Smartphone-Based Photogrammetric Modelling

“…Many papers can be found in the literature comparing results achieved with different solutions [5], direct calliper measures [6,17], orthogonal photography [26], CT [27], and 3D photogrammetry images [17,[27][28][29][30]. They permit some general conclusions to be drawn: first, calliper measurements are a bit smaller (1-4 mm [17], around 2% [5]) than the digital photogrammetric results, possibly due to the pressure of the callipers and/or the use of skullcaps for photogrammetric solutions [17]; second, although CT yields the best solution [6], it is not recommended since the patient has to be sedated [5], and it constitutes an avoidable exposure to radiation that entails a higher risk of malignancies in later life; third, other solutions, such as orthogonal photography [6] or, better, 3D photogrammetry, since it is more flexible in terms of image acquisition ("fast, easy, and independent of the examiner" [27]) are preferred.…”