Preliminary quantitative assessment of surgical outcomes in Craniosynostosis correction procedures: A 3D-Morphometric comparison.

Abstract

Craniosynostosis (or Craniostenosis) is a premature pathological fusion of cranial sutures that leads to skull deformities and potential neurological complications. This study focuses on a common non-syndromic form and aims to quantitatively assess surgical outcomes immediately after corrective procedures. The purpose is to present a technique for morphometric analysis in patients with sagittal synostosis. Several surgical techniques can be adopted for this condition, and their effectiveness depends on the severity and age of the patient. Morphometric indices, such as the Cephalic Index (CI), Intracranial Volume (ICV), Frontal Sagittal Index (FSI), and Occipital Sagittal Index (OSI), are commonly used for evaluation. Midsagittal Vector Analysis (MSVA) and volumetric approaches have been applied to assess cranial morphology. However, most studies focus on long-term outcomes, comparing affected children to healthy peers. In this work, 3D reconstructions obtained from computed tomography (CT) scans, taken before and after surgery, are analyzed using an innovative implementation of the MSVA method and a volumetric approach to assess immediate corrective actions quantitatively. The study was conducted on 12 patients, collaborating with the Biomedical 3D-Printing Laboratory and the Craniofacial Surgery Unit at Bambino Gesù Children's Hospital in Rome. The surgical technique implies craniotomy, bone removal, frontal incisions, and cranial vault remodelling to normalize skull shape and intracranial volume. These vectorial and volumetric analyses allow for a more precise evaluation of immediate surgical outcomes and provide valuable insights for optimizing surgical procedures for this cranial condition.