Three-Dimensional Photographic Analysis of Outcome After Helmet Treatment of a Nonsynostotic Cranial Deformity

Abstract

Cranial asymmetries due to nonsynostotic deformation of the skull have been reported with increasing frequency during the last decade. Conservative approaches using helmets and physiotherapy have been shown to be effective in their treatment. Traditionally, documentation has been carried out using anthropometric caliper measurements. The present study evaluates the use of a new three-dimensional photographic system in the improved validation of changes in head deformities. This prospective analysis introduces a new technique for digital anthropometric measurement. The study series comprised 181 children with nonsynostotic head deformities. Three-dimensional photographs were obtained before and after treatment with an orthotic helmet device. The oblique head diagonals and head width and length were measured from three-dimensional photographs using 3dMD customer software. The cranial vault asymmetry index, cranial vault asymmetry, and cranial index were compared before and after treatment. The measurements obtained on three-dimensional images were able to demonstrate significant improvement in early infant cranial deformity after treatment with an orthotic helmet. The cranial vault asymmetry index in plagiocephaly was reduced by 7.16%, and cranial vault asymmetry was reduced by 0.86 cm. The cranial index in brachycephaly decreased by 7.32%. In children with combined plagiocephaly and brachycephaly, the cranial vault asymmetry index improved by 5.77%, cranial vault asymmetry improved by 0.71 cm, whereas the cranial index changed by 5.48%. Three-dimensional photogrammetry can support treatment control in patients with deformational plagiocephaly. This new technology offers several advantages such as easy acquisition of images, detection of landmarks without patient movement, repeatable measurements without patient discomfort, and the opportunity for unbiased evaluation.

Orthotic (helmet) therapy in the treatment of plagiocephaly

“…43 Of the 21 primary research articles, there were 7 Class II studies, 10,11,13,17,25,31,36 1 Class III study, 33 and 13 Class IV studies. 5,6,9,12,[14][15][16]20,26,35,37,39,41 …”

“…Six articles were excluded because they were not directly related to cranial orthoses therapy in deformational plagiocephaly (n = 5), or involved nonhuman subjects (n = 1). Of the remaining 36 papers, 21 were primary research literature articles, 5,6,[9][10][11][12][13][14][15][16][17]20,25,26,31,33,[35][36][37]39,41 12 were reviews, 7,8,[22][23][24]29,30,32,34,38,40,42 2 were letters, 3,18 and 1 described the methodology of an ongoing randomized controlled trial. 43 Of the 21 primary research articles, there were 7 Class II studies, 10,11,13,17,25,31,36 1 Class III study, 33 and 13 Class IV studies.…”

“…tained using anthropometric calipers. Recent technological advances such as photogrammetry 25,35 or 3D surface scanning with a laser 31,41 allow clinicians and researchers to use more accurate and efficient measurement. 41 The common anthropometric measurements used are explained in Table 2.…”

Uso da estereofotogrametria nas deformidades craniofaciais: revisão sistemática

“…Probably, this finding is justified by the fact that the 3dMD ® system has been a pioneer in the market (launched in 2005 6 ), among the systems capturing the three-dimensional morphology of the face, combining stereophotogrammetry with the projection of a random pattern of structured light. There are several advantages at tributed to such a system, especially accuracy 3,7,9,10,12,14,16 , reproducibility 3,11 , quick acquisition of images 3,8,[10][11][12][13][14] , and the possibility of capturing the facial texture 11,12 . When analyzing the advantages listed about the other systems, it appears that the majority are already included in the list for 3dMD ® .…”

“…Seven articles had no control group 3,[8][9][10][11]17,24 , whereas 12 articles included a control group 7,[12][13][14][15][16][18][19][20][21][22][23] .…”