BACKGROUND: Surgical intervention for metopic synostosis is largely based on a subjective impression of the presence and severity of trigonocephaly. Several objective methods have been proposed to characterize phenotypic severity, but these methods are imprecise or impractical. The purpose of this investigation was to develop a practical and reliable quantitative method to assess trigonocephaly using computed tomographic (CT) data. METHODS: Clinical and administrative databases were queried to identify sequential patients referred for evaluation of possible metopic synostosis. Age-matched comparative controls were selected from a previously described pediatric craniofacial normative database. Craniofacial CT data were assessed as two-dimensional axial series, three-dimensional reconstructions, and multiplanar reconstructions. Six methods were then evaluated for quantifying the interfrontal angle (IFA). Each method was critically appraised with respect to accuracy, precision, and practicality. RESULTS: Thirty-six (n = 36) sequential metopic cases and 107 normative controls were selected for analysis. Of the 6 methods assessed, the most reliable method involved measurement of the IFA formed between the anterior-most point of the cranium and the supraorbital notches using multiplanar reconstructions reoriented relative to the Frankfort horizontal plane. With this method, mean (SD) normal and metopic IFAs were found to be 144.8 (8.5) degrees (range, 125.3-159.7 degrees) and 117.74 (9.0) degrees (range, 92.3-136.8 degrees), respectively. Age and sex did not significantly affect the IFA. Intraobserver and interobserver variances were 0.90 and 0.94, respectively. Receiver operating characteristic analysis showed an area under the curve of 0.986, indicative of an excellent diagnostic test. CONCLUSIONS: Measurement of the IFA as described is an accurate, precise, and practical quantitative measure for the diagnosis of trigonocephaly.
BACKGROUND: Surgical intervention for metopic synostosis is largely based on a subjective impression of the presence and severity of trigonocephaly. Several objective methods have been proposed to characterize phenotypic severity, but these methods are imprecise or impractical. The purpose of this investigation was to develop a practical and reliable quantitative method to assess trigonocephaly using computed tomographic (CT) data. METHODS: Clinical and administrative databases were queried to identify sequential patients referred for evaluation of possible metopic synostosis. Age-matched comparative controls were selected from a previously described pediatric craniofacial normative database. Craniofacial CT data were assessed as two-dimensional axial series, three-dimensional reconstructions, and multiplanar reconstructions. Six methods were then evaluated for quantifying the interfrontal angle (IFA). Each method was critically appraised with respect to accuracy, precision, and practicality. RESULTS: Thirty-six (n = 36) sequential metopic cases and 107 normative controls were selected for analysis. Of the 6 methods assessed, the most reliable method involved measurement of the IFA formed between the anterior-most point of the cranium and the supraorbital notches using multiplanar reconstructions reoriented relative to the Frankfort horizontal plane. With this method, mean (SD) normal and metopic IFAs were found to be 144.8 (8.5) degrees (range, 125.3-159.7 degrees) and 117.74 (9.0) degrees (range, 92.3-136.8 degrees), respectively. Age and sex did not significantly affect the IFA. Intraobserver and interobserver variances were 0.90 and 0.94, respectively. Receiver operating characteristic analysis showed an area under the curve of 0.986, indicative of an excellent diagnostic test. CONCLUSIONS: Measurement of the IFA as described is an accurate, precise, and practical quantitative measure for the diagnosis of trigonocephaly.
Authors: David García-Mato; Mónica García-Sevilla; Antonio R Porras; Santiago Ochandiano; Juan V Darriba-Allés; Roberto García-Leal; José I Salmerón; Marius George Linguraru; Javier Pascau Journal: Int J Comput Assist Radiol Surg Date: 2021-01-08 Impact factor: 2.924
Authors: Alexandra Junn; Jacob Dinis; Sacha C Hauc; Madeleine K Bruce; Kitae E Park; Wenzheng Tao; Cameron Christensen; Ross Whitaker; Jesse A Goldstein; Michael Alperovich Journal: Cleft Palate Craniofac J Date: 2021-11-17
Authors: Riddhish Bhalodia; Lucas A Dvoracek; Ali M Ayyash; Ladislav Kavan; Ross Whitaker; Jesse A Goldstein Journal: J Craniofac Surg Date: 2020 May/Jun Impact factor: 1.172
Authors: David García-Mato; Antonio R Porras; Santiago Ochandiano; Gary F Rogers; Roberto García-Leal; José I Salmerón; Javier Pascau; Marius George Linguraru Journal: Plast Reconstr Surg Glob Open Date: 2021-11-11
Authors: Ryan K Badiee; Emma Popowitz; Ian T Mark; Andre Alcon; Joan Hwang; Eve Rorison; Kurtis I Auguste; William Y Hoffman; Peter P Sun; Jason H Pomerantz Journal: Plast Reconstr Surg Glob Open Date: 2022-02-09