The Esthetic Perception of Morphological Severity in Scaphocephalic Patients is Correlated With Specific Head Geometrical Features

Abstract

Objective To investigate the relationship between perception of craniofacial deformity, geometric head features, and 3D head shape analyzed by statistical shape modeling (SSM). Patients A total of 18 unoperated patients with scaphocephaly (age = 5.2 ± 1.1m)—6 were followed-up after spring-assisted cranioplasty (SAC) (age = 9.6 ± 1.5m)—and 6 controls (age = 6.7 ± 2.5m). Main Outcome Measures 3D head shapes were retrieved from 3D scans or computed tomography (CTs). Various geometrical features were measured: anterior and posterior prominence, take-off angle, average anterior and posterior lateral and horizontal curvatures, cranial index (CI) (cranial width over length), and turricephaly index (TI) (cranial height over length). SSM and principal component analysis (PCA) described shape variability. All models were 3D printed; the perception of deformity was blindly scored by 9 surgeons and 1 radiologist in terms of frontal bossing (FB), occipital bulleting (OB), biparietal narrowing (BN), low posterior vertex (LPV), and overall head shape (OHS). Results A moderate correlation was found between FB and anterior prominence (r = 0.56, P < .01) and take-off angle (r = − 0.57, P < .01). OB correlated with average posterior lateral curvature (r = 0.43, P < 0.01) similarly to BPN (r = 0.55, P < .01) and LPV (r = 0.43, P < .01). OHS showed strong correlation with CI (r = − 0.68, P < .01) and TI (r = 0.63, P< .01). SSM Mode 1 correlated with OHS (r = 0.66, p < .01) while Mode 3 correlated with FB (r = − 0.58, P < .01). Conclusions Esthetic cranial appearance in craniofacial patients is correlated to specific geometric parameters and could be estimated using automated methods such as SSM.

3D Analysis of the Cranial and Facial Shape in Craniosynostosis Patients: A Systematic Review

“…Four studies employ principal component analysis (PCA), a statistical procedure that identifies and quantifies shape variations from a standard or ‘normal’ population 33,55–57 . By concentrating on the most significant variations, PCA enables the differentiation of distinct types of craniosynostosis.…”

“…Of these, 30 publications were considered as reproducible (Supplemental Digital Content Table 3, http://links.lww.com/SCS/F940). To measure width or length, there were 3 methods described, including measurements using a base plane in combination with a measurement plane, 11,14,18,20,22,24,25,29–32 measurements using only a base plane 16,27,33–35, or measurements based on landmarks 13,18,22,36–43 …”

“…The first 2 methods use a base plane. For this base plane, the most commonly used landmarks are the left and right tragus and the nasion/sellion, which is used in 9 publications, 11,14,20,22,24,27,33–35 or the left and right tragus and the subnasale, which is used in 2 publications 25,29 . With the maximum width and length, the cephalic index can be calculated, which has been performed in 23 publications 11,13,14,16,18,22,24,25,27,29–39,41–43 …”

Automated surgical planning in spring-assisted sagittal craniosynostosis correction using finite element analysis and machine learning

“…A 3D calvarial model was developed considering average length, width, height, and anterior and posterior curvatures for infant skulls around 5-month-old with sagittal craniosynostosis PLOS ONE [19,20] using Solidworks 2021 (Dassault Systèmes, Ve ´lizy-Villacoublay, France). The 3D calvarial model is given as a S1 File.…”