Quantification of Bilateral Coronal Synostosis: Anterior Brachycephaly

OBJECTIVES: Very few studies focus on the quantification of severity of synostotic anterior brachycephaly. Aim of this study is to implement Utrecht Cranial Shape Quantifier (UCSQ) in brachycephaly patients to objectively quantify severity for both clinical and research purposes. DESIGN: Retrospective study. SETTING: Primary craniofacial center. PATIENTS AND PARTICIPANTS: Fifteen preoperative patients with bilateral coronal craniosynostosis (age <1.5 years). INTERVENTION: Utrecht Cranial Shape Quantifier was used to quantify severity using the variables: width of frontal peak ratio, difference forehead peak and occiput peak, and width between sides of the head. MAIN OUTCOME MEASURE(S): The UCSQ variables were combined and related to Argenta clinical classification and cephalic index (CI) using 1-way analysis of variance (ANOVA). All parameters were derived from computed tomography scans. RESULTS: Statistically significant differences were found between group means of UCSQ in the 3 categories of Argenta (ANOVA; F(2,12) = 22.461; P < .01). Tukey post hoc test showed a significant difference between Argenta types 1 and 2, types 1 and 3, and types 2 and 3 (all P < .01). Statistically significant differences were found between traditional CI and Argenta types (F(2,12) = 4.956; P = .03). Tukey post hoc test showed significantly difference between Argenta type 1 and 3 (P = .02). No differences were found between other types. Low correlation was found between UCSQ and CI (r = 0.47). CONCLUSIONS: Utrecht Cranial Shape Quantifier objectively captures and quantifies the shape of synostotic brachycephaly, and we therefore developed a suitable method to put severity of synostotic (anterior) brachycephaly into numbers.