Quantifying the effect of corrective surgery for trigonocephaly: A non-invasive, non-ionizing method using three-dimensional handheld scanning and statistical shape modelling.
Trigonocephaly in patients with metopic synostosis is corrected by fronto-orbital remodelling (FOR). The aim of this study was to quantitatively assess aesthetic outcomes of FOR by capturing 3D forehead scans of metopic patients pre- and post-operatively and comparing them with controls. Ten single-suture metopic patients undergoing FOR and 15 age-matched non-craniosynostotic controls were recruited at Great Ormond Street Hospital for Children (UK). Scans were acquired with a three-dimensional (3D) handheld camera and post-processed combining 3D imaging software. 3D scans were first used for cephalometric measurements. Statistical shape modelling was then used to compute the 3D mean head shapes of the three groups (FOR pre-op, post-op and controls). Head shape variations were described via principal component analysis (PCA). Cephalometric measurements showed that FOR significantly increased the forehead volume and improved trigonocephaly. This improvement was supported visually by pre- and post-operative computed mean 3D shapes and numerically by PCA (p < 0.001). Compared with controls, post-operative scans showed flatter foreheads (p < 0.001). In conclusion, 3D scanning followed by 3D statistical shape modelling enabled the 3D comparison of forehead shapes of metopic patients and non-craniosynostotic controls, and demonstrated that the adopted FOR technique was successful in correcting bitemporal narrowing but overcorrected the rounding of the forehead.
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom. Electronic address: n.florez@ucl.ac.uk.
Naiara
N
Rodriguez-Florez
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Özge K
ÖK
Göktekin
Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom; UCL Institute of Cardiovascular Science (Head: Prof. A. Hingorani), Centre for Cardiovascular Imaging, London WC1E 6BT, United Kingdom.
Jan L
JL
Bruse
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Alessandro
A
Borghi
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Freida
F
Angullia
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Paul G M
PG
Knoops
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Maik
M
Tenhagen
Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Justine L
JL
O'Hara
Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom; Department of Maxillofacial Surgery, Erasmus MC, 3015 CE Rotterdam, The Netherlands.
Maarten J
MJ
Koudstaal
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom; UCL Institute of Cardiovascular Science (Head: Prof. A. Hingorani), Centre for Cardiovascular Imaging, London WC1E 6BT, United Kingdom.
Silvia
S
Schievano
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
N U Owase
NU
Jeelani
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
Greg
G
James
UCL Great Ormond Street Institute of Child Health (Head: Prof. R. Smyth), London WC1N 1EH, United Kingdom; Craniofacial Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, United Kingdom.
David J
DJ
Dunaway
D002508:Cephalometry / Q000379:methods*; D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005546:Forehead / Q000000981:diagnostic imaging / Q000601:surgery*; D006257:Head / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008297:Male; D008953:Models, Anatomic
3D scanning/photography; Craniosynostosis; Fronto-orbital remodelling; Principal component analysis; Statistical shape analysis; Trigonocephaly