Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of fronto-orbital reconstruction surgery for the treatment of metopic synostosis in Chinese population

  • Original Article
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy of fronto-orbit reconstruction surgery on pediatric metopic synostosis via an image-based 3D reconstruction in Chinese population.

Methods

Thirty pediatric metopic synostosis patients who received fronto-orbital reconstruction surgery in the Children’s Hospital of Nanjing Medical University, Department of Neurosurgery, from January 2007 to December 2018 were analyzed in the study. Here we use the Mimics 20.0 software to reconstruct patients’ cranial thin-section CT scan images from pre- and post-operation and control groups. Then the data of intracranial volume, frontal volume, orbital hypertelorism, ECA, ZF, and ORA were analyzed using the paired t-test or Wilcoxon matched-pairs signed-ranks test.

Results

The age of these patients was 15.83 ± 16.12 months. After surgery, the mean frontal volume was enlarged from 92.75 ± 26.97 to 138.62 ± 47.97 cm3 (P < 0.0001), and the intracranial volume was enhanced from 976.87 ± 230.83 to 1059.44 ± 217.98 cm3 (P < 0.0001). In the meantime, the ECA was changed from 108.02 ± 8.17 to 134 ± 5.59° (P < 0.0001). In line with the alteration of the parameters mentioned above, the head shapes in all patients were also significantly improved after the surgery with no obvious complications.

Conclusion

Fronto-orbit reconstruction surgery is a safe and effective treatment for pediatric metopic synostosis. Computer-aided 3D reconstruction could serve as a quantitative strategy to evaluate the efficacy of craniofacial surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Abbott AH, Netherway DJ, Niemann DB, Clark B, Yamamoto M, Cole J et al (2000) CT-determined intracranial volume for a normal population. J Craniofac Surg 11:211–223

    Article  CAS  Google Scholar 

  2. Beckett JS, Chadha P, Persing JA, Steinbacher DM (2012) Classification of trigonocephaly in metopic synostosis. Plast Reconstr Surg 130:442e–447e

    Article  CAS  Google Scholar 

  3. Cohen SR, Persing JA (1998) Intracranial pressure in single-suture craniosynostosis. Cleft Palate Craniofac J 35:194–196

    Article  CAS  Google Scholar 

  4. Freudlsperger C, Steinmacher S, Bachli H, Somlo E, Hoffmann J, Engel M (2015) Metopic synostosis: measuring intracranial volume change following fronto-orbital advancement using three-dimensional photogrammetry. J Craniomaxillofac Surg 43:593–598

    Article  Google Scholar 

  5. Gault DT, Renier D, Marchac D, Ackland FM, Jones BM (1990) Intracranial volume in children with craniosynostosis. J Craniofac Surg 1:1–3

    Article  CAS  Google Scholar 

  6. Gociman B, Blagg R, Agko M, Goodwin I, Kestle JR, Siddiqi F (2014) The metopic angle: a novel assessment tool of the trigonocephalic frontal deformity and its correction. J Craniofac Surg 25:2101–2104

    Article  Google Scholar 

  7. Gripp KW, Zackai EH, Stolle CA (2000) Mutations in the human TWIST gene. Hum Mutat 15:479

    Article  CAS  Google Scholar 

  8. Havlik RJ, Azurin DJ, Bartlett SP, Whitaker LA (1999) Analysis and treatment of severe trigonocephaly. Plast Reconstr Surg 103:381–390

    Article  CAS  Google Scholar 

  9. Kan SH, Elanko N, Johnson D, Cornejo-Roldan L, Cook J, Reich EW et al (2002) Genomic screening of fibroblast growth-factor receptor 2 reveals a wide spectrum of mutations in patients with syndromic craniosynostosis. Am J Hum Genet 70:472–486

    Article  CAS  Google Scholar 

  10. Karabagli P (2013) Pathology in metopic synostosis. Childs Nerv Syst 29:2165–2170

    Article  Google Scholar 

  11. Kellogg R, Allori AC, Rogers GF, Marcus JR (2012) Interfrontal angle for characterization of trigonocephaly: part 1: development and validation of a tool for diagnosis of metopic synostosis. J Craniofac Surg 23:799–804

    Article  Google Scholar 

  12. Kjaer I (1995) Human prenatal craniofacial development related to brain development under normal and pathologic conditions. Acta Odontol Scand 53:135–143

    Article  CAS  Google Scholar 

  13. Maltese G, Tarnow P, Wikberg E, Bernhardt P, Lagerlof JH, Tovetjarn R et al (2014) Intracranial volume before and after surgical treatment for isolated metopic synostosis. J Craniofac Surg 25:262–266

    Article  Google Scholar 

  14. Mardini S, Alsubaie S, Cayci C, Chim H, Wetjen N (2014) Three-dimensional pre-operative virtual planning and template use for surgical correction of craniosynostosis. J Plast Reconstr Aesthet Surg 67:336–343

    Article  Google Scholar 

  15. McKay DR, Davidge KM, Williams SK, Ellis LA, Chong DK, Teixeira RP et al (2010) Measuring cranial vault volume with three-dimensional photography: a method of measurement comparable to the gold standard. J Craniofac Surg 21:1419–1422

    Article  Google Scholar 

  16. Netherway DJ, Abbott AH, Anderson PJ, David DJ (2005) Intracranial volume in patients with nonsyndromal craniosynostosis. J Neurosurg 103:137–141

    PubMed  Google Scholar 

  17. Posnick JC, Armstrong D, Bite U (1995) Metopic and sagittal synostosis: intracranial volume measurements prior to and after cranio-orbital reshaping in childhood. Plast Reconstr Surg 96:299–309; discussion 310-295

    Article  CAS  Google Scholar 

  18. Ruiz-Correa S, Starr JR, Lin HJ, Kapp-Simon KA, Sze RW, Ellenbogen RG et al (2008) New severity indices for quantifying single-suture metopic craniosynostosis. Neurosurgery 63:318–324; discussion 324-315

    Article  Google Scholar 

  19. Sgouros S, Hockley AD, Goldin JH, Wake MJ, Natarajan K (1999) Intracranial volume change in craniosynostosis. J Neurosurg 91:617–625

    Article  CAS  Google Scholar 

  20. Speltz ML, Kapp-Simon KA, Cunningham M, Marsh J, Dawson G (2004) Single-suture craniosynostosis: a review of neurobehavioral research and theory. J Pediatr Psychol 29:651–668

    Article  Google Scholar 

  21. van der Meulen J, van der Hulst R, van Adrichem L, Arnaud E, Chin-Shong D, Duncan C et al (2009) The increase of metopic synostosis: a pan-European observation. J Craniofac Surg 20:283–286

    Article  Google Scholar 

  22. Vergnaud E, Vecchione A, Blanot S, di Rocco F, Arnaud E, Renier D et al (2012) Reducing blood losses and transfusion requirements in craniosynostosis surgery: an endless quest? Anesthesiology 116:733–734; author reply 734-735

    Article  Google Scholar 

Download references

Funding

This work was supported by Nanjing Medical Technology Development Fund (YKK16189).

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Children’s Hospital of Nanjing Medical University, Nanjing, China

    Qing Yan, Junping He, Zhe Gao, Dezhi Qiu, Lei Zheng, Xianli Zhang & Gang Wang

Authors
  1. Qing Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Junping He
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhe Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dezhi Qiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lei Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xianli Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gang Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gang Wang.

Ethics declarations

Conflict of interest

The authors have declared that no competing interests exist.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(XLSX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yan, Q., He, J., Gao, Z. et al. Evaluation of fronto-orbital reconstruction surgery for the treatment of metopic synostosis in Chinese population. Childs Nerv Syst 37, 1167–1174 (2021). https://doi.org/10.1007/s00381-020-04977-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-020-04977-w

Key words

Search

Navigation