3D Analysis of the Cranial and Facial Shape in Craniosynostosis Patients: A Systematic Review
Open accessAbstract
With increasing interest in 3D photogrammetry, diverse methods have been developed for craniofacial shape analysis in craniosynostosis patients. This review provides an overview of these methods and offers recommendations for future studies. A systematic literature search was used to identify publications on 3D photogrammetry analyses in craniosynostosis patients until August 2023. Inclusion criteria were original research reporting on 3D photogrammetry analyses in patients with craniosynostosis and written in English. Sixty-three publications that had reproducible methods for measuring cranial, forehead, or facial shape were included in the systematic review. Cranial shape changes were commonly assessed using heat maps and curvature analyses. Publications assessing the forehead utilized volumetric measurements, angles, ratios, and mirroring techniques. Mirroring techniques were frequently used to determine facial asymmetry. Although 3D photogrammetry shows promise, methods vary widely between standardized and less conventional measurements. A standardized protocol for the selection and documentation of landmarks, planes, and measurements across the cranium, forehead, and face is essential for consistent clinical and research applications.
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Practical limitations include cost of equipment and need for patient compliance during image acquisition.
“This is accompanied by several practical limitations in clinical, like the considerable cost of equipment and the need for patient compliance during image acquisition- particularly challenging in very young children who may be unable to remain still [70].”
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 [70]
The Discussion’s “Type 3D Imaging Modalities” section says patients must hold still for several seconds during scanning and that portable scanners cost less than static devices. The Recommendations and Conclusion section adds that young children may struggle to remain seated. The paper does not establish that equipment costs are considerable; it gives only a relative cost comparison. Page numbers were not available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredImage quality can be compromised by artefacts, such as hair when protective caps are not used.
“Image quality can also be compromised by artefacts, for example caused by hair when protective caps are not used [70].”
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 [70]
Measurement reliability can be compromised by different imaging techniques and inconsistent landmark placement.
“However, measurement reliability can be compromised by different imaging techniques and inconsistent landmark placement, leading to uncertainty in the measurements [70].”
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 [70]
Reliable identification of anatomical landmarks may be difficult in cases of abnormal cranial morphology.
“Moreover, the reliable identification of anatomical landmarks may be difficult in cases of abnormal cranial morphology [70].”
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 [70]
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Rizvi, I., Hallac, R. R., Geisler, E. L., Perez, J. K., Ainuz, B. Y., Pressler, M. P., Jackson, S. A., Skolnick, G. B., Smyth, M. D., Seaward, J. R., et al. (2023) · Journal of Neurosurgery: Pediatrics · doi:10.3171/2023.5.peds22528 · Cited by 13 · see citing works
The Natural History of Cranial Morphology in Sagittal Craniosynostosis
Al‐Shaqsi, S., Zellner, E., Ching, J. A., Forrest, C., & Phillips, J. H. (2018) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000004298 · Cited by 13 · see citing works
Rodriguez-Florez, N., Borghi, A., Yauwan, D. D., Heuntinck, P., Bruse, J. L., Tenhagen, M., Göktekin, Ö. K., Angullia, F., Schievano, S., Dunaway, D. J., et al. (2020) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000006863 · Cited by 12 · see citing works
Radiation-free quantification of head malformations in craniosynostosis patients from 3D photography
Oh, A. K., Mastromanolis, M., Paniagua, B., Enquobahrie, D. A., Linguraru, M. G., Tu, L., Porras, A. R., Leporé, N., Tsering, D., Keating, R. F., et al. (2018) · SPIE Medical Imaging: Computer-Aided Diagnosis · doi:10.1117/12.2295374 · Cited by 11 · see citing works
Öwall, L., Darvann, T. A., Hove, H., Bøgeskov, L., Kreiborg, S., & Hermann, N. V. (2019) · The Cleft Palate-Craniofacial Journal · doi:10.1177/1055665618821821 · Cited by 11 · see citing works
Svalina, A., Vuollo, V., Serlo, W. S., Sinikumpu, J., Silvola, A., & Salokorpi, N. (2021) · Child s Nervous System · doi:10.1007/s00381-021-05434-y · Cited by 11 · see citing works
Martini, M., Klausing, A., Messing‐Jünger, M., & Lüchters, G. (2017) · Journal of Cranio-Maxillofacial Surgery · doi:10.1016/j.jcms.2017.06.023 · Cited by 10 · see citing works
Cao, R., Chen, B., Xu, H. X., Cai, Y., & Liu, W. (2022) · Medicine · doi:10.1097/md.0000000000031922 · Cited by 10 · see citing works
Photogrammetric evaluation of corrective surgery for trigonocephaly
Kuehle, R., Ewerbeck, N., Rückschloß, T., Ristow, O., Damaty, A. E., Freudlsperger, C., Hoffmann, J., & Engel, M. (2021) · International Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.ijom.2021.06.003 · Cited by 10 · see citing works
Britto, J. A., Gwanmesia, I., & Leshem, D. (2012) · Child s Nervous System · doi:10.1007/s00381-012-1806-9 · Cited by 9 · see citing works
Nguyen, H. T., Washington, G. N., Cepeda, A., Littlefield, T., Obinero, C. G., Greives, M. R., & Nguyen, P. D. (2023) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000009433 · Cited by 9 · see citing works
Bahşi̇, İ., Orhan, M., & Kervancıoğlu, P. (2021) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000007900 · Cited by 8 · see citing works
Harrison, L. M., Mathew, D. P., Cole, N. A., Sachdeva, S., Hallac, R. R., & Derderian, C. A. (2023) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000010277 · Cited by 7 · see citing works
Abdel‐Alim, T., Tio, P. A. E., Kurniawan, M. S. I. C., Mathijssen, I. M. J., Dirven, C. M. F., Niessen, W. J., Roshchupkin, G. V., & van Veelen, M. C. (2023) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000009448 · Cited by 7 · see citing works
Self-citationTu, L., Rogers, G. F., Linguraru, M. G., Porras, A. R., Oh, A. K., Leporé, N., Buck, B. S. G. C., Tsering, D., Enquobahrie, D. A., & Keating, R. (2019) · SPIE Medical Imaging: Computer-Aided Diagnosis · doi:10.1117/12.2512272 · Cited by 7 · see citing works
Classification of Skull Shape Deformities Related to Craniosynostosis on 3D Photogrammetry
Kronig, S. A. J., Kronig, O. D. M., Vrooman, H. A., & van Adrichem, L. N. A. (2022) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000008912 · Cited by 7 · see citing works
Clinical metrics and tools for provider assessment and tracking of trigonocephaly
Leclair, N. K., Chern, J. J., Ahn, E. S., Chamis, M., Paro, M. R., Lambert, W. A., Stoltz, P., Hersh, D. S., Martin, J. E., & Bookland, M. J. (2023) · Journal of Neurosurgery Pediatrics · doi:10.3171/2023.2.peds22511 · Cited by 6 · see citing works
Ramamurthi, A., Hallac, R. R., Chou, P., Kenyon, L., & Derderian, C. A. (2021) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000007642 · Cited by 6 · see citing works
Şakar, M., Haidar, H., Sönmez, Ö., Erdoğan, O., Saçak, B., Bayri, Y., & Dağçınar, A. (2022) · Journal of Neurosurgery Pediatrics · doi:10.3171/2022.1.peds21553 · Cited by 6 · see citing works
de Jong, G., Meulstee, J. W., van Lindert, E. J., Borstlap, W. A., Maal, T., & Delye, H. (2023) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000010701 · Cited by 5 · see citing works
Utility of Preoperative Helmet Molding Therapy in Patients With Isolated Sagittal Craniosynostosis
Zapatero, Z. D., Slawinski, S. K., Kosyk, M. S., Kalmar, C. L., Cheung, L., Carlson, A. R., Swanson, J. W., Taylor, J. A., & Bartlett, S. P. (2021) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000008251 · Cited by 5 · see citing works
Borghi, A., Heutinck, P. A. T., Rodríguez-Flórez, N., Koudstaal, M. J., Ruggiero, F., Ajami, S., Schievano, S., Jeelani, O., & Dunaway, D. J. (2022) · The Cleft Palate-Craniofacial Journal · doi:10.1177/10556656221111307 · Cited by 5 · see citing works
Elawadly, A., Smith, L., Borghi, A., Abdelaziz, K. I., Silva, A. H. D., Dunaway, D. J., Jeelani, O., Ong, J., & James, G. (2022) · Journal of Neurosurgery Pediatrics · doi:10.3171/2022.2.peds21546 · Cited by 5 · see citing works
Pfaff, M. J., Bruce, M. K., Erpenbeck, S. P., Mittal, A., Beiriger, J. W., Zhu, X., Dvoracek, L. A., & Goldstein, J. A. (2021) · The Cleft Palate-Craniofacial Journal · doi:10.1177/10556656211062843 · Cited by 5 · see citing works
Kronig, S. A. J., Kronig, O. D. M., Vrooman, H. A., & van Adrichem, L. N. A. (2022) · The Cleft Palate-Craniofacial Journal · doi:10.1177/10556656221100679 · Cited by 4 · see citing works
Medina‐Pizarro, M., Imahiyerobo, T. A., Odigie, E., Guadix, S. W., de Silva, N., Buontempo, M., Souweidane, M. M., & Hoffman, C. E. (2023) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000009485 · Cited by 3 · see citing works
Harrison, L. M., Jackson, S., & Hallac, R. R. (2023) · FACE · doi:10.1177/27325016231160558 · Cited by 3 · see citing works
Flagged first, then by citations
3 of the 107 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Görg, C., Elkhill, C., Chaij, J. M., Royalty, K., Nguyen, P. D., French, B. M., Cruz-Guerrero, I. A., & Porras, A. R. (2024) · Computers & Graphics · doi:10.1016/j.cag.2024.104056 · Cited by 6 · see citing works
Tio, P. A. E., Abdel‐Alim, T., Roshchupkin, G. V., Versnel, S. L., Pleumeekers, M. M., van Veelen, M. C., & Mathijssen, I. M. J. (2024) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000011753 · Cited by 5 · see citing works
Self-citationLif, H. M., Taverne, M., D, G. P. M., Khonsari, R. H., & Nowinski, D. J. (2025) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000011235 · Cited by 4 · see citing works
Surface scanning and imaging in craniofacial surgery
Viaud‐Murat, E. M., Patel, D. M., & Tatum, S. A. (2025) · Current Opinion in Otolaryngology & Head & Neck Surgery · doi:10.1097/moo.0000000000001062 · Cited by 3 · see citing works
Hermann, J., Raak, C. K., Ostermann, T., & Scharbrodt, W. (2025) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-025-03978-9 · Cited by 2 · see citing works
“Additionally, newer approaches combine these morphometric results with patient-reported outcomes, providing a more comprehensive evaluation of treatment success [70].”
InfluentialElkhill, C., Cruz-Guerrero, I. A., Liu, J., Linguraru, M. G., Alexander, A., French, B. M., & Porras, A. R. (2024) · International Symposium on Medical Information Processing and Analysis (SIPAIM) · doi:10.1109/sipaim62974.2024.10783545 · Cited by 2 · see citing works
Rückschloß, T., Zittel, S., Hassanein, E., Damaty, A. E., Krieg, S. M., Ristow, O., Hoffmann, J., & Engel, M. (2025) · Neurosurgical FOCUS · doi:10.3171/2024.10.focus24582 · Cited by 1 · see citing works
Wormian bones in simple sagittal synostosis: incidence and correlations
Miranda, P., Plaza-Ramírez, E., Pancucci, G., Verdú-Ferrer, A., Castello-Guarch, B., Serrano, F. M., & Simal-Julián, J. A. (2025) · Child s Nervous System · doi:10.1007/s00381-025-06910-5
Lin, J., Ji, X.-T., Wang, J., Zhang, Q., Chen, Z., Li, P., Yang, Y., Yang, G., Wu, S., & Gu, S. (2025) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000011982
Denadai, R., Alvim, M. K. M., Kang, Y., Tu, J. C., de Campos, B. M., Ghizoni, E., Tedeschi, H., Yasuda, C. L., & Cendes, F. (2025) · PeerJ · doi:10.7717/peerj.20201
Vetrano, I. G., Barbotti, A., Galbiati, T. F., Porto, E., Erbetta, A., Mazzoleni, F., Conni, M., & Valentini, L. G. (2025) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000011293
A 2D Photo Score for Phenotypic Severity in Unilateral Coronal Synostosis Patients
Tjaberinga, M. C., & Workgroup, E. C. (2026) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000012989
A 3-Dimensional Morphable Model of the Apert Mandible
Ramjeeawon, A., van de Lande, L. S., O'Sullivan, E., Oosting, A.-J. C., Bulstrode, N., Bloch, K., Khonsari, R. H., Schievano, S., & Dunaway, D. J. (2026) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000012979
Park, D., Jung, Y. U., Kim, B. J., Yoo, J., Chung, J., Jeon, S., Kwon, H., Kwon, S., Choi, K. Y., Shin, J., et al. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1871961
Yaşin, S., & Bahşi̇, İ. (2026) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000013402
Yamada, M. (2026) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000013523
- Authors
- Kurniawan, M. S. I. C., Tio, P. A. E., Abdel Alim, T., Roshchupkin, G., Dirven, C. M. F., Pleumeekers, M. M., Mathijssen, I. M. J., & van Veelen, M.-L. C.
- Affiliations
- Department of Plastic and Reconstructive Surgery
- Erasmus MC (NL)
- Department of Neurosurgery
- Corresponding author
- Kurniawan, Melissa S.I.C.
- Tio, Pauline A.E.
- Pleumeekers, Mieke M.
- Mathijssen, Irene M.J.
- ORCID
- Venue
- Journal of Craniofacial Surgery
- Published
- 2024-03-18
- Volume
- 35
- Issue
- 3
- Pages
- 813-821
- ISSN
- 1049-2275 (ISSN-L)
- PMC
- PMC11045556
- OpenAlex
- W4392914767
- Cited by
- 16
- References
- 107
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 3
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Craniofacial Surgery (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
- Physical Sciences › Mathematics › Geometry and Topology › Morphological variations and asymmetry
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Keywords
- craniosynostosis, 3D photogrammetry, head shape, facial shape, facial asymmetry, curvature analysis, volume measurement, measurement standardization
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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