A Novel Quantitative Method for Evaluating Surgical Outcomes in Craniosynostosis: Pilot Analysis for Metopic Synostosis
Open accessAbstract
Objective assessment of head shape has been an elusive goal in the management of craniosynostosis patients. Clinical judgment, craniometric indices, and computed tomography scans are the primary means through which a surgeon assesses this patient population. The purpose of this study was to examine and discuss the utility of the STARscanner for evaluation of surgical outcomes in metopic synostosis patients. A retrospective chart review of patients with metopic synostosis who underwent fronto-orbital advancement with pre- and postoperative STARscanner imaging at Texas Children's Hospital was performed. Two patients were identified and evaluation and discussion of the data produced by the STARscanner was undertaken. A novel symmetry index created by the authors, called the anterior–posterior volume ratio (APVR), was discussed for use in metopic synostosis patients. The postoperative growth metrics demonstrated an interval increase compared with the preoperative data. The anterior symmetry ratio, posterior symmetry ratio, overall symmetry ratio, cranial vault volumes, cranial vault asymmetry index, and cephalic ratio were not found to be useful in evaluating resolution of dysmorphology after fronto-orbital advancement in metopic synostosis. The APVR does not characterize dysmorphology, but may help show degree of expansion of the anterior cranial vault after fronto-orbital advancement. The STARscanner imaging device does not appear to have significant utility in characterizing head shape for surgical outcomes assessment in metopic synostosis. The minor utility of this device may be that it is a safe and fast way to derive growth parameters for both short-term and long-term follow-up of cranial vault remodeling.
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Data collected with the 3D stereography method can be used for post-operative production of a personalised helmet orthosis.
“In addition to finding a diagnosis with the 3D stereography method described from de Jong et al. 2020, this method also enables an effective follow-up assessment, and the data collected can also be used for the post-operative production of a personalised helmet orthosis [77–79].”
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 [78]
The introductory passage labeled Abstract (page unavailable) says orthotists use STARscanner measurements to make cranial remolding orthoses, supporting the use of scan data to make a fitted helmet. It identifies deformational plagiocephaly as the device’s primary application, however, and does not say the orthosis is made postoperatively. The Conclusion (page unavailable) discusses postoperative use for growth monitoring, not helmet production. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe 3D stereography method described by de Jong et al. 2020 enables effective follow-up assessment.
“In addition to finding a diagnosis with the 3D stereography method described from de Jong et al. 2020, this method also enables an effective follow-up assessment, and the data collected can also be used for the post-operative production of a personalised helmet orthosis [77–79].”
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 [78]
The Discussion and Conclusion (pages not provided) say STARscanner measurements may allow short- and long-term postoperative monitoring of skull growth, but the device has little utility for assessing whether surgery resolved craniofacial dysmorphology. The paper describes a laser-based STARscanner, not a method described by de Jong et al. in 2020. Its mention of using measurements to make cranial orthoses does not establish postoperative helmet production. (LLM, conf=0.87)
Experimental — accuracy not yet measured
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- Authors
- Weathers, W. M., Khechoyan, D., Wolfswinkel, E. M., Mohan, K., Nagy, A., Bollo, R. J., Buchanan, E. P., & Hollier, L. H.
- Affiliations
- Baylor College of Medicine (US)
- Texas Children's Hospital (US)
- Corresponding author
- Weathers, William M.
- Venue
- Craniomaxillofacial Trauma & Reconstruction
- Publisher
- MDPI AG
- Published
- 2014-03
- Volume
- 7
- Issue
- 1
- Pages
- 1-7
- ISSN
- 1943-3875 (ISSN-L)
- 1943-3883
- PMC
- PMC3931770
- OpenAlex
- W2086418985
- Cited by
- 35
- References
- 20
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 4 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 1 · 2014: 1
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Craniomaxillofacial Trauma & Reconstruction (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (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
- metopic synostosis, craniosynostosis, fronto-orbital advancement, surgical outcome assessment, head shape, cranial vault asymmetry, cranial vault remodeling
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