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验证 Skully Care 作为一种快速量化头颅畸形的方法。

Validation of Skully Care as a Fast Method for Quantifying Positional Cranial Deformities.

机构信息

Department of Plastic and Reconstructive Surgery and Hand Surgery, 8124University Medical Center Utrecht, the Netherlands.

出版信息

Cleft Palate Craniofac J. 2022 Sep;59(9):1107-1113. doi: 10.1177/10556656211035022. Epub 2021 Sep 24.

DOI:10.1177/10556656211035022
PMID:34559019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9411692/
Abstract

OBJECTIVE

Craniofacial measuring is valuable for diagnosis and evaluation of growth and treatment of positional skull deformities. Plagiocephalometry (PCM) quantifies skull deformities and is proven to be reliable and valid. However, PCM needs direct skin contact with thermoplastic material, is laborious and time-consuming. Therefore, Skully Care (SC) was developed to measure positional skull deformities with a smartphone application.

DESIGN

SC is retrospectively compared to PCM.

SETTING

Pediatric physiotherapy centers.

PATIENTS

Age ≤1 year, analyzed or treated for positional skull deformities.

INTERVENTIONS

A total of 60 skull shape analyses were performed.

MAIN OUTCOME MEASURES

The main outcome measures employed are Pearson correlation coefficient between cranial vault asymmetry index (CVAI; in SC) and oblique diameter difference index (ODDI; in PCM) and between cranial index (CI; in SC) and cranial proportional index (CPI; in PCM). Mann-Whitney test determined difference of time consumption between PCM and SC.

RESULTS

High correlation was found between CVAI and ODDI (= 0.849; < .01) in positional plagiocephaly and very high correlation between CI and CPI (  0.938; < .01) in positional brachycephaly. SC is significantly faster than PCM (< .001).

CONCLUSIONS

SC is valid in analyzing positional skull deformities and strongly correlates to PCM, the gold standard in daily physiotherapy practice. The combination of simplicity, validity, speed, and user and child convenience makes SC a promising craniofacial measuring method in daily practice. SC has potential to be the modern successor for analyzing positional skull deformities.

摘要

目的

颅面测量对于诊断、评估生长和治疗位置性颅骨畸形具有重要价值。颅面测量法（PCM）可量化颅骨畸形，且已被证实具有可靠性和有效性。然而，PCM 需要与热塑材料直接接触，既费力又耗时。因此，Skully Care（SC）应用智能手机开发出来，用于测量位置性颅骨畸形。

设计

SC 与 PCM 进行回顾性比较。

地点

儿科物理治疗中心。

患者

年龄≤1 岁，因位置性颅骨畸形接受分析或治疗。

干预措施

共进行了 60 例颅骨形状分析。

主要观察指标

采用颅骨穹窿不对称指数（CVAI；SC 中）与斜径差异指数（ODDI；PCM 中）以及颅指数（CI；SC 中）与颅比例指数（CPI；PCM 中）之间的皮尔逊相关系数作为主要观察指标。Mann-Whitney U 检验用于比较 PCM 和 SC 的时间消耗差异。

结果

在位置性斜头畸形中，CVAI 与 ODDI 之间存在高度相关性（=0.849；<0.01），在位置性短头畸形中，CI 与 CPI 之间存在极高相关性（  0.938；<0.01）。SC 明显快于 PCM（<0.001）。

结论

SC 可有效分析位置性颅骨畸形，与 PCM 高度相关，后者是日常物理治疗实践中的金标准。SC 简单、有效、快速，且方便使用者和儿童，具有很大的应用前景，可能成为分析位置性颅骨畸形的现代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/b36306947a05/10.1177_10556656211035022-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/3b1b2de7e254/10.1177_10556656211035022-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/1045ea343149/10.1177_10556656211035022-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/fa1f30c50d96/10.1177_10556656211035022-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/b36306947a05/10.1177_10556656211035022-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/3b1b2de7e254/10.1177_10556656211035022-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/1045ea343149/10.1177_10556656211035022-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/fa1f30c50d96/10.1177_10556656211035022-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7639/9411692/b36306947a05/10.1177_10556656211035022-fig4.jpg

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本文引用的文献

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New diagnostic approach of the different types of isolated craniosynostosis.不同类型孤立性颅缝早闭的新诊断方法。
Eur J Pediatr. 2021 Apr;180(4):1211-1217. doi: 10.1007/s00431-020-03860-9. Epub 2020 Nov 5.
2
Introducing a new method for classifying skull shape abnormalities related to craniosynostosis.介绍一种用于对与颅缝早闭相关的颅骨形状异常进行分类的新方法。
Eur J Pediatr. 2020 Oct;179(10):1569-1577. doi: 10.1007/s00431-020-03643-2. Epub 2020 Apr 17.
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Treatment of Deformational Plagiocephaly With Physiotherapy.物理治疗矫正扁头畸形
J Craniofac Surg. 2019 Oct;30(7):2008-2013. doi: 10.1097/SCS.0000000000005665.
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Plagiocephaly Severity Scale to Aid in Clinical Treatment Recommendations.用于辅助临床治疗建议的斜头畸形严重程度量表。
J Craniofac Surg. 2017 May;28(3):717-722. doi: 10.1097/SCS.0000000000003520.
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Diagnosis of infant synostotic and nonsynostotic cranial deformities: a review for pediatricians.婴儿骨性连接性和非骨性连接性颅骨畸形的诊断：给儿科医生的综述
Rev Paul Pediatr. 2016 Dec;34(4):495-502. doi: 10.1016/j.rpped.2016.01.004. Epub 2016 May 12.
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Guideline for Care of Patients With the Diagnoses of Craniosynostosis: Working Group on Craniosynostosis.颅缝早闭诊断患者护理指南：颅缝早闭工作组
J Craniofac Surg. 2015 Sep;26(6):1735-807. doi: 10.1097/SCS.0000000000002016.
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BMJ. 2014 May 1;348:g2741. doi: 10.1136/bmj.g2741.
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Cleft Palate Craniofac J. 2010 Sep;47(5):447-53. doi: 10.1597/09-026.
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