Alfredo Cepeda, H. T. Nguyen, Chioma G. Obinero, G. Washington, T. Littlefield, M. Greives, P. D. Nguyen
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A survey was administered to 14 independent raters, who were asked to determine treatment success based on subjective visual assessment of preoperative and post-banding images. Patients were considered to have successful therapy when ≥75% of raters were in agreeance. Thirteen patients met inclusion criteria. Average age at surgery was 3.5 months, with 53.9% of these patients deemed as a successful outcome on aggregate reviewer scores. For patients with successful treatment, there was a trend toward younger at surgery (2.9 months vs 4.2 months, P = .09) and at initiation of helmeting (3.3 months vs 4.8 months, P = .07). Regional root mean square identified significant differences between frontal and temporal (14.04 mm vs 7.39 mm, P = .02) and temporal and parietal (7.39 mm vs 15.37 mm, P = .002) regions. Average postoperative IFA was significantly improved compared to preoperative values (128.19° vs 117.9°, P = .02). Logistic regression modeling found no significant predictors of success. Though not statistically significant, patients with MC with successful outcomes following ESC and banding were younger at surgery and time of helmeting. Our analysis of regional cranial growth and IFA demonstrated significant differences, which coincide with expected morphologic changes in this patient population. Our results demonstrate the potential for this technology in surgical evaluation and support the importance of early diagnosis and treatment by craniofacial surgeons.","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characterization of Regional Morphological Changes in Metopic Craniosynostosis Following Endoscopic Strip Craniectomy With Postoperative Helmeting: Predictors for Success\",\"authors\":\"Alfredo Cepeda, H. T. Nguyen, Chioma G. Obinero, G. Washington, T. Littlefield, M. Greives, P. D. Nguyen\",\"doi\":\"10.1177/27325016231191638\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Metopic craniosynostosis (MC) represents 10% to 25% of craniosynostosis cases. Endoscopic-assisted strip craniectomy (ESC) with orthotic molding therapy provides a minimally invasive alternative to open fronto-orbital advancement. Herein, we describe a 3D photogrammetry methodology for measurement of regional cranial growth and inter-frontal angle (IFA) as well as examine factors that may contribute to successful outcomes after ESC. A retrospective review was performed on patients with MC treated with ESC and band therapy from 2015 to 2019. Patients obtained 3D photogrammetry preoperatively, postoperatively, and post-helmet therapy. A survey was administered to 14 independent raters, who were asked to determine treatment success based on subjective visual assessment of preoperative and post-banding images. Patients were considered to have successful therapy when ≥75% of raters were in agreeance. Thirteen patients met inclusion criteria. Average age at surgery was 3.5 months, with 53.9% of these patients deemed as a successful outcome on aggregate reviewer scores. For patients with successful treatment, there was a trend toward younger at surgery (2.9 months vs 4.2 months, P = .09) and at initiation of helmeting (3.3 months vs 4.8 months, P = .07). Regional root mean square identified significant differences between frontal and temporal (14.04 mm vs 7.39 mm, P = .02) and temporal and parietal (7.39 mm vs 15.37 mm, P = .002) regions. Average postoperative IFA was significantly improved compared to preoperative values (128.19° vs 117.9°, P = .02). Logistic regression modeling found no significant predictors of success. Though not statistically significant, patients with MC with successful outcomes following ESC and banding were younger at surgery and time of helmeting. Our analysis of regional cranial growth and IFA demonstrated significant differences, which coincide with expected morphologic changes in this patient population. 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引用次数: 0
摘要
异位性颅缝闭闭(MC)占颅缝闭闭病例的10%至25%。内镜辅助条形颅骨切除术(ESC)与矫形成型治疗提供了一种微创替代开放式额眶前进。在此,我们描述了一种用于测量区域颅骨生长和额骨夹角(IFA)的3D摄影测量方法,并研究了可能有助于ESC后成功结果的因素。回顾性分析2015年至2019年接受ESC和腕带治疗的MC患者。患者术前、术后和头盔治疗后均进行了三维摄影测量。对14名独立评分者进行了一项调查,他们被要求根据术前和术后图像的主观视觉评估来确定治疗成功。当≥75%的评分者同意时,患者被认为治疗成功。13例患者符合纳入标准。手术的平均年龄为3.5个月,53.9%的患者在总评分上被认为是成功的结果。对于治疗成功的患者,在手术时(2.9个月对4.2个月,P = 0.09)和开始戴头盔时(3.3个月对4.8个月,P = 0.07)有年轻化的趋势。区域均方根发现额叶和颞叶区域(14.04 mm vs 7.39 mm, P = 0.02)以及颞叶和顶叶区域(7.39 mm vs 15.37 mm, P = 0.002)之间存在显著差异。术后平均IFA较术前显著改善(128.19°vs 117.9°,P = 0.02)。逻辑回归模型没有发现成功的显著预测因素。虽然没有统计学意义,但在ESC和绑带后取得成功的MC患者在手术和戴头盔时更年轻。我们对区域颅骨生长和IFA的分析显示了显著的差异,这与该患者人群的预期形态学变化相吻合。我们的研究结果证明了该技术在外科评估中的潜力,并支持颅面外科医生早期诊断和治疗的重要性。
Characterization of Regional Morphological Changes in Metopic Craniosynostosis Following Endoscopic Strip Craniectomy With Postoperative Helmeting: Predictors for Success
Metopic craniosynostosis (MC) represents 10% to 25% of craniosynostosis cases. Endoscopic-assisted strip craniectomy (ESC) with orthotic molding therapy provides a minimally invasive alternative to open fronto-orbital advancement. Herein, we describe a 3D photogrammetry methodology for measurement of regional cranial growth and inter-frontal angle (IFA) as well as examine factors that may contribute to successful outcomes after ESC. A retrospective review was performed on patients with MC treated with ESC and band therapy from 2015 to 2019. Patients obtained 3D photogrammetry preoperatively, postoperatively, and post-helmet therapy. A survey was administered to 14 independent raters, who were asked to determine treatment success based on subjective visual assessment of preoperative and post-banding images. Patients were considered to have successful therapy when ≥75% of raters were in agreeance. Thirteen patients met inclusion criteria. Average age at surgery was 3.5 months, with 53.9% of these patients deemed as a successful outcome on aggregate reviewer scores. For patients with successful treatment, there was a trend toward younger at surgery (2.9 months vs 4.2 months, P = .09) and at initiation of helmeting (3.3 months vs 4.8 months, P = .07). Regional root mean square identified significant differences between frontal and temporal (14.04 mm vs 7.39 mm, P = .02) and temporal and parietal (7.39 mm vs 15.37 mm, P = .002) regions. Average postoperative IFA was significantly improved compared to preoperative values (128.19° vs 117.9°, P = .02). Logistic regression modeling found no significant predictors of success. Though not statistically significant, patients with MC with successful outcomes following ESC and banding were younger at surgery and time of helmeting. Our analysis of regional cranial growth and IFA demonstrated significant differences, which coincide with expected morphologic changes in this patient population. Our results demonstrate the potential for this technology in surgical evaluation and support the importance of early diagnosis and treatment by craniofacial surgeons.
期刊介绍:
Head & Face Medicine is a multidisciplinary open access journal that publishes basic and clinical research concerning all aspects of cranial, facial and oral conditions.
The journal covers all aspects of cranial, facial and oral diseases and their management. It has been designed as a multidisciplinary journal for clinicians and researchers involved in the diagnostic and therapeutic aspects of diseases which affect the human head and face. The journal is wide-ranging, covering the development, aetiology, epidemiology and therapy of head and face diseases to the basic science that underlies these diseases. Management of head and face diseases includes all aspects of surgical and non-surgical treatments including psychopharmacological therapies.