de Jong Guido, Tolhuisen Manon, Meulstee Jene, van der Heijden Ferdi, van Lindert Erik, Borstlap Wilfred, Maal Thomas, Delye Hans
Department of Neurosurgery, RadboudUMC, Nijmegen, The Netherlands; MIRA Institute for BMT and TM, Enschede, The Netherlands.
Department of Neurosurgery, RadboudUMC, Nijmegen, The Netherlands.
J Craniomaxillofac Surg. 2017 May;45(5):661-671. doi: 10.1016/j.jcms.2017.02.007. Epub 2017 Feb 12.
Radiation-free 3D post-operative sequential follow-up in craniosynostosis is hindered by the lack of consistent markers restricting evaluation to subjective comparison. However, using the computed cranial focal point (CCFP), it is possible to perform correct sequential image superposition and objective evaluation. We used this technique for mean volume and shape change evaluation of the head utilizing 3D photos after endoscopically assisted trigonocephaly surgery.
We performed a mean head shape and volume evaluation on age grouped 3D photos (n = 86) of children who underwent endoscopically assisted strip craniectomy with helmet therapy. We used CT-scans of healthy children as reference. We performed a mean shape evolution analysis and calculated the anterior fossa to total volume ratio (A/T-ratio). The volume- and A/T-ratio pattern were compared with the reference group.
The mean anterior fossa volume evolved from 336 ml (33.4% A/T-ratio) pre-surgery to 664 ml (36.0% A/T-ratio) at 37-48 months post-surgery. Both groups have a near similar volume- and A/T-ratio pattern over time. The first 18 months show a predominant growth around the resected metopic suture. Between 18 and 24 months we observed mostly anterior orbital rim growth. From 24 months till 36-48 months the head grows predominantly at the temporal area. The least outward growth was observed at the temporal bones.
Using a novel technique we were able to objectively evaluate head shape and volume using stereophotogrammetry after endoscopically assisted strip craniectomy. The A/T-ratio and volume growth pattern of endoscopically treated patients is near identical to that of the normal reference group.
颅缝早闭术后无辐射的三维连续随访因缺乏一致的标志物而受到阻碍，使得评估只能局限于主观比较。然而，利用计算颅焦点（CCFP），可以进行正确的序列图像叠加和客观评估。我们使用这种技术，通过三维照片对头在内镜辅助三角头畸形手术后的平均体积和形状变化进行评估。
我们对接受内镜辅助条带颅骨切除术并佩戴头盔治疗的儿童按年龄分组的三维照片（n = 86）进行了平均头部形状和体积评估。我们将健康儿童的CT扫描作为参考。我们进行了平均形状演变分析，并计算了前颅窝与总体积比（A/T比）。将体积和A/T比模式与参考组进行比较。
平均前颅窝体积从术前的336毫升（A/T比为33.4%）发展到术后37 - 48个月时的664毫升（A/T比为36.0%）。两组随时间推移的体积和A/T比模式几乎相似。最初18个月，切除的额缝周围生长占主导。在18至24个月之间，我们观察到主要是眶前缘生长。从24个月到36 - 48个月，头部主要在颞部生长。颞骨向外生长最少。
使用一种新技术，我们能够在内镜辅助条带颅骨切除术后通过立体摄影测量客观评估头部形状和体积。内镜治疗患者的A/T比和体积生长模式与正常参考组几乎相同。
