title: Objectification of cranial vault correction for craniosynostosis by three-dimensional photography.
abstract: OBJECTIVE
  Correction of craniosynostosis is necessary in predominant cases. Surgical planning usually requires a preoperative CT to estimate the bony and intracerebral structures. A postoperative CT scan would involve a significant dose of radiation, which carries an elevated risk of malignant tumor development in later life. This study was performed to demonstrate the quality of three-dimensional (3D) photogrammetry when objectifying perioperative changes in craniofacial surgery.
  
  
  METHODS
  Twenty-eight patients with different premature craniosynostoses were analyzed photogrammetrically before and after surgical correction. 3D changes in cranial distances, symmetry and volumes were evaluated. A statistical covariance analysis excluded changes in cranial shape caused by physiological head growth.
  
  
  RESULTS
  The Cephalic Index in Scaphocephaly changed from 75.1% to a median value of 77.4%. The anterior symmetry ratio for coronal synostoses improved from 0.943 to 0.949 (a value of 1.0 represents perfect symmetry). The posterior symmetry ratio improved from 0.733 to 0.808 postoperatively in one single lambdoidal synostosis. In trigonocephaly, the median anterior skull volume rose from 528 to 601 ml.
  
  
  CONCLUSIONS
  3D photogrammetry has great potential to track and objectify the clinical course of surgical correction of craniosynostoses. Craniofacial changes become highly reproducible and demonstrate clinical utility based on this technology.
authors.affiliation: University hospital Giessen, Department of Maxillofacial surgery, Plastic Surgery, Klinikstr. 33, 35385 Giessen, Germany. jan-falco.wilbrand@uniklinikum-giessen.de
authors.forename: Jan-Falco
authors.initials: JF
authors.lastname: Wilbrand
authors.forename: Alexander
authors.initials: A
authors.lastname: Szczukowski
authors.forename: Joerg-Christoph
authors.initials: JC
authors.lastname: Blecher
authors.forename: Joern
authors.initials: J
authors.lastname: Pons-Kuehnemann
authors.forename: Petros
authors.initials: P
authors.lastname: Christophis
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Howaldt
authors.forename: Heidrun
authors.initials: H
authors.lastname: Schaaf
mesh_terms: D002508:Cephalometry / Q000379:methods; D003393:Cranial Sutures / Q000002:abnormalities / Q000601:surgery; D003398:Craniosynostoses / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008297:Male; D009777:Occipital Bone / Q000002:abnormalities / Q000601:surgery; D010294:Parietal Bone / Q000002:abnormalities / Q000601:surgery; D010780:Photogrammetry / Q000379:methods*; D059041:Plagiocephaly / Q000601:surgery; D012189:Retrospective Studies; D012886:Skull / Q000254:growth & development / Q000601:surgery*