title: Volume measurements on three-dimensional photogrammetry after extended strip versus total cranial remodeling for sagittal synostosis: A comparative cohort study.
abstract: BACKGROUND
  Surgery for sagittal synostosis aims at correction of skull shape and restoration of growth potential. Small cranial volume is associated with raised intracranial pressure (ICP). Although many techniques have been described, information on postoperative volume related to early and late remodeling is lacking.
  
  
  METHODS
  Between 2004 and 2008, a total of 95 patients were collected who underwent either early extended strip craniectomy or late total cranial remodeling according to age of presentation. Volume was measured on three-dimensional (3D) photogrammetry. Volume measurements were related to cranial index (CI), head circumference (HCsd), and signs of raised ICP. In a small subset of patients, volume measurements on 3D photogrammetry were assessed for inter- and intrarater reliability and compared to 3D computed tomography (CT).
  
  
  RESULTS
  Volume was increased in all patients before and after surgery compared to normative values. Postoperatively, late total cranial remodeling resulted in a slightly larger volume than early extended strip craniectomy. Volume measurements showed a good correlation with HCsd (0.67) and a poor relationship with CI (0.13). Headache occurred more frequently in patients with a lower cranial volume. Although papilledema and reoperation showed the same trend, the numbers were too small for statistical analysis. Reproducibility of volume measurements on 3D photogrammetry was high, as was the correlation with measurements on CT.
  
  
  CONCLUSIONS
  Late total cranial remodeling results in a larger postoperative volume, as measured on 3D photogrammetry, than extended strip craniectomy. Clinical signs of raised ICP occur more frequently in patients with a smaller volume. To measure volume, 3D photogrammetry is a good alternative to CT.
authors: Erasmus University Medical Center Rotterdam, Department of Neurosurgery, The Netherlands. Electronic address: m.l.c.vanveelen@erasmusmc.nl.
authors: Marie-Lise C
authors: MC
authors: van Veelen
authors: Erasmus University Medical Center Rotterdam, Department of Plastic and Reconstructive Surgery and Hand Surgery, The Netherlands.
authors: Marielle
authors: M
authors: Jippes
authors: Erasmus University Medical Center Rotterdam, Department of Neurosurgery, The Netherlands.
authors: Julius-Carl A
authors: JA
authors: Carolina
authors: Erasmus University Medical Center Rotterdam, Department of Biostatistics, The Netherlands.
authors: Johan
authors: J
authors: de Rooi
authors: Erasmus University Medical Center Rotterdam, Department of Neurosurgery, The Netherlands.
authors: Clemens M F
authors: CMF
authors: Dirven
authors: Erasmus University Medical Center Rotterdam, Department of Plastic and Reconstructive Surgery and Hand Surgery, The Netherlands.
authors: Leon N A
authors: LNA
authors: van Adrichem
authors: Erasmus University Medical Center Rotterdam, Department of Plastic and Reconstructive Surgery and Hand Surgery, The Netherlands.
authors: Irene M
authors: IM
authors: Mathijssen
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D003398:Craniosynostoses / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure; D008297:Male; D015588:Observer Variation; D010780:Photogrammetry / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
keywords: 3D photogrammetry; Cranial volume; Sagittal synostosis; Surgery