Nieberle Felix, Spoerl Steffen, Lottner Lisa-Marie, Spanier Gerrit, Schuderer Johannes G, Fiedler Mathias, Maurer Michael, Ludwig Nils, Meier Johannes K, Ettl Tobias, Reichert Torsten E, Taxis Juergen
Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
Diagnostics (Basel). 2023 May 11;13(10):1707. doi: 10.3390/diagnostics13101707.
This study compared manual and digital measurements of plagiocephaly and brachycephaly in infants and evaluated whether three-dimensional (3D) digital photography measurements can be used as a superior alternative in everyday clinical practice. A total of 111 infants (103 with plagiocephalus and 8 with brachycephalus) were included in this study. Head circumference, length and width, bilateral diagonal head length, and bilateral distance from the glabella to the tragus were assessed by manual assessment (tape measure and anthropometric head calipers) and 3D photographs. Subsequently, the cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated. Measured cranial parameters and CVAI were significantly more precise using 3D digital photography. Manually acquired cranial vault symmetry parameters were at least 5 mm lower than digital measurements. Differences in CI between the two measuring methods did not reach significance, whereas the calculated CVAI showed a 0.74-fold decrease using 3D digital photography and was highly significant ( < 0.001). Using the manual method, CVAI calculations overestimated asymmetry, and cranial vault symmetry parameters were measured too low, contributing to a misrepresentation of the actual anatomical situation. Considering consequential errors in therapy choices, we suggest implementing 3D photography as the primary tool for diagnosing deformational plagiocephaly and positional head deformations.
本研究比较了婴儿斜头畸形和短头畸形的手动测量与数字测量，并评估了三维（3D）数字摄影测量在日常临床实践中是否可作为一种更优的替代方法。本研究共纳入111名婴儿（103名患有斜头畸形，8名患有短头畸形）。通过手动评估（卷尺和人体测量头卡尺）和3D照片评估头围、长度和宽度、双侧对角头长以及从眉间到耳屏的双侧距离。随后，计算颅指数（CI）和颅穹不对称指数（CVAI）。使用3D数字摄影测量的颅骨参数和CVAI明显更精确。手动获取的颅穹对称参数比数字测量至少低5毫米。两种测量方法之间的CI差异未达到显著水平，而使用3D数字摄影计算的CVAI下降了0.74倍，且具有高度显著性（<0.001）。使用手动方法时，CVAI计算高估了不对称性，颅穹对称参数测量过低，导致对实际解剖情况的错误呈现。考虑到治疗选择中的相应误差，我们建议将3D摄影作为诊断变形性斜头畸形和体位性头部畸形的主要工具。
