gms | German Medical Science

Objective: Non-syndromic craniosynostosis is in general clinically obvious and does not require extensive imaging. Disadvantages of radiation e.g. in children younger than 1 year of age are well-known and non-radiating diagnostic techniques are available for diagnosis and follow-up in these patients. A 3D morphometric method basing on a photographic holography technique is able to provide exact metric information about craniofacial shape and volume in patients with head deformities. Skull ultrasound is also useful for identifying closure of cranial sutures.

Methods: A series of 104 patients with non-syndromic craniosynostosis was included in a prospective investigation in order to evaluate a 3D camera-mirror system for scanning the cranofacial parameters pre- and post operatively. The result of the cranioplastic surgery in each patient was measured using headcircumference, volume, cephalic index (CI) and was visualized using matched color-coded images for the visualization of changes in the head shape. A preop scan as well as follow-up scans at 6 and 12 months are obtained and evaluated regarding objective values.

Results: All patients showed an augmentation of the craniofacial volume postoperatively and subsequent growth of the head during the follow-up period. Asymmetrical deformities showed a stable symmetric appearance and cephalic indices remained in adequate ranges. Positive changes of CI were most significant after 6 months and less marked after 12 months. Brachycephalic relapses were more frequent compared to other types of craniosynostosis. Arrested head growth was not observed. The scanning was well-tolerated and less time-consuming than 3D CT scans under anesthesia or sedation.

Conclusions: The management of non-syndromic craniosynostosis using a morphometric method is suitable for the assessment and follow-up evaluation of craniofacial deformities and has the great advantage of avoiding radiation and anesthesia for diagnostic procedures especially in young children.