Department of Neurosurgery, Oulu University Hospital, Oulu, Finland.
Medical Research Center, Oulu University Hospital, Oulu, Finland.
Childs Nerv Syst. 2022 Apr;38(4):781-788. doi: 10.1007/s00381-021-05434-y. Epub 2021 Dec 23.
The aim of this study was to investigate the craniofacial and aesthetic characteristics of adult metopic and sagittal craniosynostosis patients operated on in early childhood compared to controls. The goal was to find objective measurements that would correlate with the patient's subjective self-evaluation of their own cosmetic appearance.
The study population consisted of 49 patients from whom 41 had premature fusion of the sagittal and in 8 of metopic suture. There were 65 age and gender matching controls from The Finish National Register. The 3D photogrammetric models were created from all patients and controls. The images were analysed using Rapidform 2006. Facial landmarks were set by the standard Farkas points. Facial symmetry parameters were calculated by using the landmarks and the mirror shell of the face. Aesthetic evaluation was done from standard photographs using panels. Subjective satisfaction with one's own appearance was evaluated using questionnaires.
Patients had the greatest asymmetry in the forehead area when compared to controls (symmetry percentage 59% versus 66%, p = 0.013). In the control group, the gap between the eyes was smaller than in the case group, resulting in an absolute 2 mm difference (p = 0.003). The area of the chin and the landmarks were more located on the left side in the patient group, resulting in up to a 1.1 mm difference between the groups (p = 0.003). Only a weak association was found between craniofacial symmetry and appearance evaluations.
Patients operated on because of sagittal and metopic synostoses were found to have facial asymmetry at long follow-up. However, the differences were < 3 mm and not clinically important. The long-term aesthetical outcome of the surgery performed because of sagittal or metopic craniosynostosis based on the 3D image evaluation was good.
本研究旨在探讨儿童期早期手术治疗的成人额-矢状颅缝早闭和冠状缝早闭患者的颅面和美学特征，并与对照组进行比较。目的是寻找与患者对自身美容外观的主观自我评价相关的客观测量值。
研究人群包括 49 名患者，其中 41 名患者矢状缝和 8 名患者冠状缝提前融合。对照组为来自芬兰国家登记处的 65 名年龄和性别匹配的患者。对所有患者和对照组进行三维摄影测量模型创建。使用 Rapidform 2006 分析图像。面部标志由 Farkas 标准点设定。使用标志和面部镜像壳计算面部对称参数。使用面板从标准照片进行美学评估。使用问卷评估对自身外观的主观满意度。
与对照组相比，患者的额部区域不对称程度最大（对称百分比 59%比 66%，p=0.013）。在对照组中，眼睛之间的间隙小于病例组，导致绝对差异为 2 毫米（p=0.003）。在患者组中，下巴和标志的区域更位于左侧，导致两组之间最大差异为 1.1 毫米（p=0.003）。仅发现颅面对称性和外观评估之间存在弱关联。
在长期随访中，发现因矢状缝和冠状缝早闭而接受手术的患者存在面部不对称。然而，差异<3 毫米，无临床意义。基于三维图像评估，因矢状缝或冠状缝颅缝早闭而进行的手术的长期美容效果良好。
