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Cited by 90Craniofacial Disorders and TreatmentsPectus Deformity Diagnosis and TreatmentForensic Anthropology and Bioarchaeology Studies

New scaphocephaly severity indices of sagittal craniosynostosis: A comparative study with cranial index quantifications

Ruiz-Correa, Salvador, Sze, Raymond W., Starr, Jacqueline R., Lin, Hen-Tzu J., Speltz, Matthew L., Cunningham, Michael L., Hing, Anne V.·2006·The Cleft Palate-Craniofacial Journal
DOI 10.1597/04-208.1
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Abstract

OBJECTIVE: To describe a novel set of scaphocephaly severity indices (SSIs) for predicting and quantifying head- and skull-shape deformity in children diagnosed with isolated sagittal synostosis (ISS) and compare their sensitivity and specificity with those of the traditional cranial index (CI). METHODS: Computed tomography head scans were obtained from 60 patients diagnosed with ISS and 41 age-matched control patients. Volumetric reformations of the skull and overlying skin were used to trace two-dimensional planes defined in terms of skull-base plane and internal or surface landmarks. For each patient, novel SSIs were computed as the ratio of head width and length as measured on each of these planes. A traditional CI was also calculated and a receiver operating characteristic curve analysis was applied to compare the sensitivity and specificity of the proposed indices with those of CI. RESULTS: Although the CI is a sensitive measure of scaphocephaly, it is not specific and therefore not a suitable predictor of ISS in many practical applications. The SSI-A provides a specificity of 95% at a sensitivity level of 98%, in contrast with the 68% of CI. On average, the sensitivity and specificity of all proposed indices are superior to those of CI. CONCLUSIONS: Measurements of cranial width and length derived from planes that are defined in terms of internal or surface landmarks and skull-base plane produce SSIs that outperform traditional CI measurements.

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  • Sphenocephaly is the most common form, occurs when the middle and posterior third of the sagittal suture are ossified, and is mainly characterised by bossing of the bregma and frontal bone, with frontal width greater than biparietal width.

    “−Sphenocephaly is the most common form and occurs when the middle and posterior third of the sagittal suture are ossified. It is mainly characterised by a bossing of the bregma and of the frontal bone. In these cases, from a bird’s eye view, the width of the frontal bone is greater than the biparietal width.”

    From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [8]

  • Batrocephaly occurs when the middle and anterior third of the sagittal suture are ossified and is characterised by pronounced occipital bossing.

    “−Batrocephaly occurs when the middle and anterior third of the sagittal suture are ossified. It is characterised by pronounced occipital bossing.”

    From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [8]

  • The sagittal suture does not ossify according to the all-or-nothing principle; different morphological forms of scaphocephaly and clinical presentations develop depending on which segments of the sagittal suture are involved.

    “The sagittal suture does not ossify according to the all-or-nothing principle. Therefore, different morphological forms of scaphocephaly and different clinical presentations may develop depending on the different segments of the sagittal suture involved in the process of craniosynostosis [8,11]:”

    From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [8]

  • Dolichocephaly occurs when the entire sagittal suture is ossified and is characterised by an elongated and narrow head.

    “−Dolichocephaly occurs when the entire sagittal suture is ossified. It is characterised by an elongated and narrow head.”

    From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [8]

  • Cynocephaly occurs when the middle third of the sagittal suture is ossified and is characterised by a bony depression behind the coronal sutures.

    “−Cynocephaly occurs when the middle third of the sagittal suture is ossified. It is characterised by a bony depression that occurs behind the coronal sutures.”

    From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [8]

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Authors
Ruiz-Correa, S., Sze, R. W., Starr, J. R., Lin, H.-T. J., Speltz, M. L., Cunningham, M. L., & Hing, A. V.
Affiliations
  • Department of Radiology, University of Washington, Seattle, Washington
  • Seattle Children's Hospital (US)
  • Department of Biomedical and Health Informatics
  • University of Washington (US)
ORCID
Venue
The Cleft Palate-Craniofacial Journal
Publisher
SAGE Publications
Published
2006-03
Volume
43
Issue
2
Pages
211-221
ISSN
  • 1055-6656 (ISSN-L)
  • 1545-1569
DOI
10.1597/04-208.1
OpenAlex
W2040565494
Cited by
90
References
42
Citations by year
2026: 1 · 2025: 1 · 2024: 6 · 2023: 6 · 2022: 8 · 2021: 9 · 2020: 6 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 7 · 2013: 4 · 2012: 2
FWCI
1.90
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The Cleft Palate-Craniofacial Journal (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Dental and Craniofacial Research (R01- DE 13813, R01DE013813)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Craniofacial Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Pectus Deformity Diagnosis and Treatment
  • Social Sciences › Arts and Humanities › Archeology › Forensic Anthropology and Bioarchaeology Studies
Keywords
scaphocephaly, sagittal craniosynostosis, cranial index, sensitivity and specificity, pediatric craniofacial surgery
MeSH terms
Cephalometry, Craniosynostoses, Female, Head, Humans, Image Processing, Computer-Assisted, Male, ROC Curve, Sensitivity and Specificity, Skull, Tomography, X-Ray Computed, Case-Control Studies

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