Intracranial Volume and Head Circumference in Children with Unoperated Syndromic Craniosynostosis

Breakey, Richard W. F.; Knoops, Paul G.M.; Borghi, Alessandro; Rodríguez-Flórez, Naiara; O’Hara, Justine; James, Greg; Dunaway, David; Schievano, Silvia; Jeelani, Owase

doi:10.1097/prs.0000000000004843

Cited by 35 publications

(46 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The expansion coefficient is tuned for each individual skull FE model: higher expansion coefficients are used when the patient is younger or when there is a longer time span between the pre-operative CT imaging and surgical intervention, or surgical intervention and post-operative CT imaging. The skull growth rate in each patient was personalised through a proportional coefficient ( k ) based on the patient pre-operative ICV and the growth curve developed by Breakey et al 37 for healthy children. Relatively high “k” values representing large LC patient intracranial volumes will result in a faster growth rate as “k” is multiplied also with the term including time (Eq.…”

Section: Discussionmentioning

confidence: 99%

“…The skull growth in the patient models was evaluated by adapting the healthy subject curve of change of ICV over time (Fig. 2 ) 37 . Isolated LC is a highly rare syndrome; therefore, a model that can predict the skull growth in these specific patients requires is not yet available.…”

Section: Discussionmentioning

confidence: 99%

“…ICV was used as the parameter representing skull size as described in 36 . ICV at time of surgery was estimated utilising an empirical model 37 which predicts the skull growth until 18 years of age as Here, ICV h represents the ICV in healthy subjects and t represents time. Surgical intervention in LC skulls is generally performed before 12 months of age, as in the analysed patients 15 .…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Computational modelling of patient specific spring assisted lambdoid craniosynostosis correction

Bozkurt

Borghi

Lande

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

Lambdoid craniosynostosis (LC) is a rare non-syndromic craniosynostosis characterised by fusion of the lambdoid sutures at the back of the head. Surgical correction including the spring assisted cranioplasty is the only option to correct the asymmetry at the skull in LC. However, the aesthetic outcome from spring assisted cranioplasty may remain suboptimal. The aim of this study is to develop a parametric finite element (FE) model of the LC skulls that could be used in the future to optimise spring surgery. The skull geometries from three different LC patients who underwent spring correction were reconstructed from the pre-operative computed tomography (CT) in Simpleware ScanIP. Initially, the skull growth between the pre-operative CT imaging and surgical intervention was simulated using MSC Marc. The osteotomies and spring implantation were performed to simulate the skull expansion due to the spring forces and skull growth between surgery and post-operative CT imaging in MSC Marc. Surface deviation between the FE models and post-operative skull models reconstructed from CT images changed between ± 5 mm over the skull geometries. Replicating spring assisted cranioplasty in LC patients allow to tune the parameters for surgical planning, which may help to improve outcomes in LC surgeries in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Computational modelling of patient specific spring assisted lambdoid craniosynostosis correction

Bozkurt

Borghi

Lande

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…where age CT is the age of the patient at the time of the CT, a and b are parameters defining the logarithmic growth (Breakey et al 2018). This equation was used to rescale the V CT = a + b * log age CT + 1 Anterior spring Posterior spring 1 3.7 5.3 S12 S12 2 5.2 5.9 S12 S12 3 7.2 8.0 S14 S14 4…”

Section: Patient-specific Fe Geometrymentioning

confidence: 99%

A population-specific material model for sagittal craniosynostosis to predict surgical shape outcomes

Borghi

Rodríguez-Flórez

Ruggiero

et al. 2019

Biomech Model Mechanobiol

Self Cite

View full text Add to dashboard Cite

Sagittal craniosynostosis consists of premature fusion (ossification) of the sagittal suture during infancy, resulting in head deformity and brain growth restriction. Spring-assisted cranioplasty (SAC) entails skull incisions to free the fused suture and insertion of two springs (metallic distractors) to promote cranial reshaping. Although safe and effective, SAC outcomes remain uncertain. We aimed hereby to obtain and validate a skull material model for SAC outcome prediction. Computed tomography data relative to 18 patients were processed to simulate surgical cuts and spring location. A rescaling model for age matching was created using retrospective data and validated. Design of experiments was used to assess the effect of different material property parameters on the model output. Subsequent material optimization-using retrospective clinical spring measurements-was performed for nine patients. A population-derived material model was obtained and applied to the whole population. Results showed that bone Young's modulus and relaxation modulus had the largest effect on the model predictions: the use of the population-derived material model had a negligible effect on improving the prediction of on-table opening while significantly improved the prediction of spring kinematics at follow-up. The model was validated using on-table 3D scans for nine patients: the predicted head shape approximated within 2 mm the 3D scan model in 80% of the surface points, in 8 out of 9 patients. The accuracy and reliability of the developed computational model of SAC were increased using population data: this tool is now ready for prospective clinical application.

show abstract

“…3 Measurement of intracranial volume (ICV) provides important information in the monitoring of craniosynostosis patients as, albeit not a direct quantification of intracranial pressure, it may provide information on the space available inside the skull and the postsurgical volume increase. [4][5][6] In order to calculate a patient's ICV, an imaging technique yielding a 3-dimensional (3D) view of the intracranial area, such as computed tomography (CT) or magnetic resonance imaging (MRI), is required. 4 Yet, MRI is not routinely used in the evaluation of craniosynostosis because of its timeconsuming nature and the need for sedation in children.…”

mentioning

confidence: 99%

Correlation of Intracranial Volume With Head Surface Volume in Patients With Multisutural Craniosynostosis

Misier

Breakey

Caron

et al. 2020

Journal of Craniofacial Surgery

Self Cite

View full text Add to dashboard Cite

Intracranial volume (ICV) is an important parameter for monitoring patients with multisutural craniosynostosis. Intracranial volume measurements are routinely derived from computed tomography (CT) head scans, which involves ionizing radiation. Estimation of ICV from head surface volumes could prove useful as 3D surface scanners could be used to indirectly acquire ICV information, using a non-invasive, non-ionizing method. Pre-and postoperative 3D CT scans from spring-assisted posterior vault expansion (sPVE) patients operated between 2008 and 2018 in a single center were collected. Patients were treated for multisutural craniosynostosis, both syndromic and non-syndromic. For each patient, ICV was calculated from the CT scans as carried out in clinical practice. Additionally, the 3D soft tissue surface volume (STV) was extracted by 3D reconstruction of the CT image soft tissue of each case, further elaborated by computer-aided design (CAD) software. Correlations were analyzed before surgery, after surgery, combined for all patients and in syndrome subgroups. Soft tissue surface volume was highly correlated to ICV for all analyses: r ¼ 0.946 preoperatively, r ¼ 0.959 postoperatively, and r ¼ 0.960 all cases combined. Subgroup analyses for Apert, Crouzon-Pfeiffer and complex craniosynostosis were highly significant as well (P < 0.001). In conclusion, 3D surface model volumes correlated strongly to ICV, measured from the same scan, and linear equations for this correlation are provided. Estimation of ICV with just a 3D surface model could thus be realized using a simple method, which does not require radiations and therefore would allow closer monitoring in patients through multiple acquisitions over time.

show abstract

Intracranial Volume and Head Circumference in Children with Unoperated Syndromic Craniosynostosis

Cited by 35 publications

References 29 publications

Computational modelling of patient specific spring assisted lambdoid craniosynostosis correction

Computational modelling of patient specific spring assisted lambdoid craniosynostosis correction

A population-specific material model for sagittal craniosynostosis to predict surgical shape outcomes

Correlation of Intracranial Volume With Head Surface Volume in Patients With Multisutural Craniosynostosis

Contact Info

Product

Resources

About