What can a morphometric study of unoperated children teach us about the natural history of metopic synostosis?

OBJECTIVE: Outcomes of surgical repair of trigonocephaly are well reported in the literature, but there is a paucity of information on the natural history of unoperated children. The authors evaluated a group of unoperated children with metopic synostosis to describe the natural change in head shape over time.

METHODS: A database was screened for scans of children with unoperated trigonocephaly (2010-2021). Multisuture cases and those with a metopic ridge were excluded. Three-dimensional surface scans (3D stereophotogrammetry/CT) were used for morphological analysis. Nine previously published parameters were used: frontal angle (FA30°), anteroposterior (AP) volume ratio (APVR), AP area ratio (APAR), AP width ratios 1 and 2 (APWR1 and APWR2), and 4 AP diagonal ratios (30° right APDR [rAPDR30], 30° left APDR [lAPDR30], 60° right APDR [rAPDR60], and 60° left APDR [lAPDR60]).

RESULTS: Ninety-seven scans were identified from a cohort of 316 patients with a single metopic suture, in which the male-to-female ratio was 2.7:1. Ages at the time of the scan ranged from 9 days to 11 years and were stratified into 4 groups: group 1, < 6 months; group 2, 6-12 months; group 3, 1-3 years; and group 4, > 3 years. Significant improvements were detected in 5 parameters (APVR, APAR, APWR1, rAPDR30, and lAPDR30) over time, whereas no significant differences were found in FA30, APWR2, rAPDR60, and lAPDR60 between age groups.

CONCLUSIONS: Forehead shape (surface area and volume), as well as narrowing and anterolateral contour at the frontal points, differed significantly over time without surgery. However, forehead angulation, narrowing, and anterolateral contour at temporal points did not show significant differences. This knowledge will aid in surgical and parental decision-making.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:33

Enthalten in:

Journal of neurosurgery. Pediatrics - 33(2024), 4 vom: 01. Apr., Seite 374-381

Sprache:

Englisch

Beteiligte Personen:

Elawadly, Ahmed M [VerfasserIn]
Smith, Luke P J [VerfasserIn]
Borghi, Alessandro [VerfasserIn]
Abdelaziz, Khaled I [VerfasserIn]
Silva, Adikarige Haritha Dulanka [VerfasserIn]
Dunaway, David J [VerfasserIn]
Jeelani, Noor Ul Owase [VerfasserIn]
Ong, Juling [VerfasserIn]
Hayward, Richard D [VerfasserIn]
James, Greg [VerfasserIn]

Links:

Volltext

Themen:

3D scans
Craniofacial
Journal Article
Metopic
Natural history
Stereophotogrammetry
Synostosis
Unoperated

Anmerkungen:

Date Completed 03.04.2024

Date Revised 03.04.2024

published: Electronic-Print

Citation Status MEDLINE

doi:

10.3171/2023.11.PEDS23227

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367321769