[Cephalometric studies on X-ray pictures to evaluate postoperative cranial growth of children with craniosynostoses].
OBJECTIVE
A preoperative CT scan seems indispensible for the evaluation of the bones and soft tissue in children with craniosynostoses. Regular postoperative follow-up is limited because of general anaesthesia and radiation exposure. Therefore, cranial growth of these children has hardly been examined so far. A method is needed to replace CT for this indication and to allow differentiated growth analysis besides clinical inspection.


METHODS
15 children (7 trigonocephalies, 4 plagiocephalies, 4 syndromal craniosynostoses) were operated on using a standardized bilateral fronto-orbital advancement. Using conventional pre- and postoperative skull roentgenograms, a craniometric analysis according to the modified method of Schmid et al. [13] was carried out.


RESULTS
A supernormal opening of the frontal angle (the forehead area) and an increase of length of the frontal base were found. Skull height and skull width were positively influenced; the growth of the dorsal skull base remained retarded in length postoperatively. There was metrically identifiable reorganization of areas distant from operation area. Results were validated by comparison with normal subjects and patient populations known from the published literature.


CONCLUSIONS
The presented method is easy, safe and exposure-reduced, and is able to assess the growth of different skull areas by means of distance and angle measurements. It should be used regularly in routine postoperative control of craniosynostoses. CT examinations should be limited to special questions of the soft tissue.
Kovács
A F
AF
Klinik und Poliklinik für Kiefer- und Plastische Gesichtschirurgie Universität Frankfurt/Main.
D000367:Age Factors; D002508:Cephalometry; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005624:Frontal Bone / Q000254:growth & development; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009915:Orbit / Q000254:growth & development; D012886:Skull / Q000254:growth & development*; D019291:Skull Base / Q000254:growth & development; D014057:Tomography, X-Ray Computed