Research Paper
Craniofacial Anomalies
A new method for three-dimensional evaluation of the cranial shape and the automatic identification of craniosynostosis using 3D stereophotogrammetry

https://doi.org/10.1016/j.ijom.2017.03.017Get rights and content

Abstract

Craniosynostosis is a congenital defect which can result in abnormal cranial morphology. Three dimensional (3D) stereophotogrammetry is potentially an ideal technique for the evaluation of cranial morphology and diagnosis of craniosynostosis because it is fast and harmless. This study presents a new method for objective characterization of the morphological abnormalities of scaphocephaly and trigonocephaly patients using 3D photographs of patients and healthy controls. Sixty 3D photographs of healthy controls in the age range of 3–6 months were superimposed and scaled. Principal component analysis (PCA) was applied to find the mean cranial shape and the cranial shape variation in this normal population. 3D photographs of 20 scaphocephaly and 20 trigonocephaly patients were analysed by this PCA model to test whether cranial deformities of scaphocephaly and trigonocephaly patients could be objectively identified. PCA was used to find the mean cranial shape and the cranial shape variation in the normal population. The PCA model was able to significantly distinguish scaphocephaly and trigonocephaly patients from the normal population. 3D stereophotogrammetry in combination with the presented method can be used to objectively identify and classify the cranial shape of healthy newborns, scaphocephaly and trigonocephaly patients.

Section snippets

Subjects

A total of 100 3D stereophotographs were included in this prospective study. This dataset included 20 3D photographs of patients with scaphocephaly and 20 3D photographs of patients with trigonocephaly. The included scaphocephaly and trigonocephaly patients suffering from isolated, non-syndromic premature closure of respectively the sagittal or the metopic suture. Diagnosis was confirmed using a computed tomography (CT) scan. The pre-operative 3D photographs of the scaphocephaly patients were

Variations in the normal population

PCA of the control group resulted in a mean cranial shape of the control population and a set of PCs describing the variations in the control population. The effect of PC1 is displayed in Fig. 2. This morphological effect is an increase of the complete frontal region to the anterior direction, including an anterior displacement of the orbital region. In total, the cranial shape became more elongated without a reduction of the lateral diameter of the cranium. PC1 accounted for 46% of the total

Discussion

The combination of 3D stereophotogrammetry and the evaluation with the use of PCA provides a new method for an objective and automatic characterization of the cranial morphology. PCA was applied on a dataset of 3D photographs to find and isolate cranial shape variations in a normal population. Using these variations, the cranial shape of scaphocephaly and trigonocephaly patients could be distinguished from a normal cranial shape. This method provides an objective tool for the physician to

Funding

None.

Competing interests

None

Ethical approval

Study protocol was approved by the medical ethical commission of the institution in which the study was carried out: 17934 filenumber NL17934.091.07.

Patient consent

Not required.

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