The value of three-dimensional photogrammetry in isolated sagittal synostosis: Impact of age and surgical technique on intracranial volume and cephalic index─a retrospective cohort study
Abstract
Purpose The aim of this study was to compare the outcome of intracranial volume (ICV) and cephalic index (CI) between two different techniques for surgical therapy of sagittal synostosis.Material and methods Between 2011 and 2015, all patients scheduled for surgical therapy of sagittal synostosis were consecutively enrolled. All patients younger than 6 months underwent early extended strip craniectomy (ESC group), and patients older than 6 months underwent late modified pi-procedure (MPP group). To measure ICV and CI, data acquisition was performed via three-dimensional photogrammetry, 1 day before (T0) and between 10 and 12 weeks after surgery (T1). Results were compared with an age-matched reference group of healthy children. Perioperative parameters, as duration of surgery and the amount of blood loss of both surgical procedures were analyzed.Results A total of 85 patients were enrolled. Of the patients, 48 underwent an extended strip craniotomy with parietal osteotomies and biparietal widening and 37 patients underwent a late modified pi-procedure. There was no significant difference between the ESC group and the MPP group regarding the efficacy of improving CI (p > 0.05). Both techniques were able to normalize CI and to improve head shape. ICV was normal compared to age-matched norm-groups with both techniques, pre- and postoperatively. However, duration of the surgical procedure and calculated blood loss were significantly lower in the ESC group (p < 0.05).Conclusion ESC and MPP were effective techniques to normalize cephalic index (CI) and improve head shape at their recommended time of surgery. Measurement of ICV and CI with 3D photogrammetry is a valid method to objectively evaluate patients before and after surgery without exposing pediatric patients to ionizing radiation.
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Photogrammetry, together with AI integration, enables reliable, radiation-free assessment of skull morphology comparable to CT scan results.
“Together with the integration of artificial intelligence into image analysis, photogrammetry enables a reliable, radiation-free assessment of skull morphology comparable to the results of a CT scan [71].”
From Developments in diagnostic and surgical techniques in children with sagittal suture craniosynostosis: a systematic review spanning the last 30 years (2025) · cites this paper as [71]
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Photogrammetry Applied to Neurosurgery: A Literature Review
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Osteoclastic craniectomy for scaphocephaly in infants results in physiological head shapes
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“Together with the integration of artificial intelligence into image analysis, photogrammetry enables a reliable, radia-tion-free assessment of skull morphology comparable to the results of a CT scan [71].”
- Authors
- Mertens, C., Wessel, E., Berger, M., Ristow, O., Hoffmann, J., Kansy, K., Freudlsperger, C., Bächli, H., & Engel, M.
- Affiliations
- University Hospital Heidelberg (DE)
- Corresponding author
- Engel, Michael
- ORCID
- Venue
- Journal of Cranio-Maxillofacial Surgery
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 45
- Issue
- 12
- Pages
- 2010-2016
- ISSN
- 1010-5182 (ISSN-L)
- OpenAlex
- W2760177810
- Cited by
- 22
- References
- 58
- Citations by year
- 2025: 5 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 1
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cranio-Maxillofacial Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Keywords
- sagittal synostosis, craniosynostosis, intracranial volume, cephalic index, 3D photogrammetry, surgical outcome assessment, blood loss, operative time
- MeSH terms
- Age Factors, Brain, Cephalometry, Craniosynostoses, Female, Humans, Infant, Male, Organ Size, Photogrammetry, Retrospective Studies, Cohort Studies, Imaging, Three-Dimensional
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