Establishment of Objective Clinical Parameters for Assessment of Trigonocephaly: Are Caliper-Derived Clinical Measures Adequate?. Issue 1 (30th January 2022)

• Record Type: Journal Article
• Authors: Yan, Yufan; McGrath, Jennifer L.; Janes, Lindsay E.; Gosain, Arun K.
• Is Part Of: Journal of craniofacial surgery. Volume 33:Issue 1(2022)
• Page Start: 259
• Page End: 263
• Publication Date: 2022-01-30
• Subjects: Calipers -- craniosynostosis -- infants -- metopic suture -- noninvasive measurements -- trigonocephaly; Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000008061
• Languages: English
• ISSNs: 1049-2275

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract : Objective: Objective clinical parameters characterizing the severity of trigonocephaly are essential given the concern for computerized tomography (CT) scans and radiation in infants. The present study seeks to develop a clinical tool by which to characterize trigonocephaly. Design: Retrospective cohort study. Setting: Tertiary academically affiliated children's medical center. Participants: A retrospective review identified patients with trigonocephaly for whom surgery was recommended (group 1) and those with metopic ridging without significant trigonocephaly (group 2). Normal age-matched controls were also evaluated (group 3). Interventions: Cranial vault caliper measurements were compared across groups. Two ratios measuring anterior vault constriction were developed: (1) bitemporal width at the mid-forehead to the biparietal width, and (2) bitemporal width at the lateral brow to the biparietal width. Main outcome measures: Bitemporal width to biparietal width (ratio). Results: Caliper measures were obtained from 19 patients in group 1, 8 patients in group 2, and 19 patients in group 3 (controls). Cranial indices were not significantly different across groups. The bitemporal width at the mid-forehead to the biparietal width ratio was significantly lower in group 1, with no difference between groups 2 and 3. The bitemporal width at the lateral brow to the biparietal width ratio was significantly different between all 3 groups, with group 1 < group 2 < group 3, respectively. Conclusions: Bitemporal to biparietal ratios are a quantitative, objective clinical measure that can be used to differentiate patients with significant trigonocephaly from those with metopic ridging but no significant cranial deformity. These findings suggest that caliper-derived indices can assist in characterizing surgically relevant cranial vault deformities secondary to metopic synostosis and may circumvent CT-based analysis.