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The metopic index: an anthropometric index for the quantitative assessment of trigonocephaly from metopic synostosis.
J Neurosurg Pediatr. 2016 Sep; 18(3):275-80.JN

Abstract

OBJECTIVE

Because the metopic suture normally fuses during infancy, there are varying degrees of severity in head shape abnormalities associated with premature fusion. A method for the objective and reproducible assessment of metopic synostosis is needed to guide management, as current methods are limited by their reliance on aesthetic markers. The object of this study was to describe the metopic index (MI), a simple anthropometric cranial measurement. The measurements can be obtained from CT scans and, more importantly, from palpable cranial landmarks, and the index provides a rapid tool for evaluating patients in both pre- and postoperative settings.

METHODS

High-resolution head CT scans obtained in 69 patients (age range 0-24 months) diagnosed with metopic craniosynostosis were retrospectively reviewed. Preoperative 3D reconstructions were available in 15 cases, and these were compared with 3D reconstructions of 324 CT scans obtained in a control group of 316 infants (age range 0-24 months) who did not have any condition that might affect head size or shape and also in a subset of this group, comprising 112 patients precisely matched to the craniosynostosis patients with respect to age and sex. Postoperative scans were available and reviewed in 9 of the craniosynostosis patients at a mean time of 7.1 months after surgical repair. 3D reconstructions of these scans were matched with controls based upon age and sex.

RESULTS

The mean preoperative MI for patients with trigonocephaly was 0.48 (SD 0.05), significantly lower than the mean values of 0.57 (SD 0.04) calculated on the basis of all 324 scans obtained in controls (p < 0.001) and 0.58 (SD 0.04) for the subset of 112 age- and sex-matched controls (p < 0.001). For 7 patients with both pre- and postoperative CT scans available for evaluation, the mean postoperative MI was 0.55 (SD 0.03), significantly greater than their preoperative MIs (mean 0.48 [SD 0.04], p = 0.001) and comparable to the mean MI of the controls (p = 0.30). In 4 patients, clinically obtained postoperative MIs by caliper measurement were comparable to measurements derived from CT (p = 0.141).

CONCLUSIONS

The MI is a useful measurement of the severity of trigonocephaly in patients with metopic synostosis. This simple quantitative assessment can potentially be used in the clinical setting to guide preoperative evaluation, surgical repair, and postoperative degree of correction.

Authors+Show Affiliations

Division of Pediatric Neurosurgery, Department of Neurosurgery, and.Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.Division of Pediatric Neurosurgery, Department of Neurosurgery, and.Division of Pediatric Neurosurgery, Department of Neurosurgery, and.Division of Pediatric Neurosurgery, Department of Neurosurgery, and.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27153376

Citation

Wang, Joanna Y., et al. "The Metopic Index: an Anthropometric Index for the Quantitative Assessment of Trigonocephaly From Metopic Synostosis." Journal of Neurosurgery. Pediatrics, vol. 18, no. 3, 2016, pp. 275-80.
Wang JY, Dorafshar AH, Liu A, et al. The metopic index: an anthropometric index for the quantitative assessment of trigonocephaly from metopic synostosis. J Neurosurg Pediatr. 2016;18(3):275-80.
Wang, J. Y., Dorafshar, A. H., Liu, A., Groves, M. L., & Ahn, E. S. (2016). The metopic index: an anthropometric index for the quantitative assessment of trigonocephaly from metopic synostosis. Journal of Neurosurgery. Pediatrics, 18(3), 275-80. https://doi.org/10.3171/2016.2.PEDS15524
Wang JY, et al. The Metopic Index: an Anthropometric Index for the Quantitative Assessment of Trigonocephaly From Metopic Synostosis. J Neurosurg Pediatr. 2016;18(3):275-80. PubMed PMID: 27153376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The metopic index: an anthropometric index for the quantitative assessment of trigonocephaly from metopic synostosis. AU - Wang,Joanna Y, AU - Dorafshar,Amir H, AU - Liu,Ann, AU - Groves,Mari L, AU - Ahn,Edward S, Y1 - 2016/05/06/ PY - 2016/5/7/entrez PY - 2016/5/7/pubmed PY - 2017/2/17/medline KW - EuD = eurion-eurion diameter KW - FPI = frontoparietal index KW - MFZ = midfrontozygomatic KW - MFZD = MFZ diameter KW - MI = metopic index KW - anthropometric indices KW - craniofacial KW - craniosynostosis KW - metopic index KW - metopic synostosis KW - trigonocephaly SP - 275 EP - 80 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 18 IS - 3 N2 - OBJECTIVE Because the metopic suture normally fuses during infancy, there are varying degrees of severity in head shape abnormalities associated with premature fusion. A method for the objective and reproducible assessment of metopic synostosis is needed to guide management, as current methods are limited by their reliance on aesthetic markers. The object of this study was to describe the metopic index (MI), a simple anthropometric cranial measurement. The measurements can be obtained from CT scans and, more importantly, from palpable cranial landmarks, and the index provides a rapid tool for evaluating patients in both pre- and postoperative settings. METHODS High-resolution head CT scans obtained in 69 patients (age range 0-24 months) diagnosed with metopic craniosynostosis were retrospectively reviewed. Preoperative 3D reconstructions were available in 15 cases, and these were compared with 3D reconstructions of 324 CT scans obtained in a control group of 316 infants (age range 0-24 months) who did not have any condition that might affect head size or shape and also in a subset of this group, comprising 112 patients precisely matched to the craniosynostosis patients with respect to age and sex. Postoperative scans were available and reviewed in 9 of the craniosynostosis patients at a mean time of 7.1 months after surgical repair. 3D reconstructions of these scans were matched with controls based upon age and sex. RESULTS The mean preoperative MI for patients with trigonocephaly was 0.48 (SD 0.05), significantly lower than the mean values of 0.57 (SD 0.04) calculated on the basis of all 324 scans obtained in controls (p < 0.001) and 0.58 (SD 0.04) for the subset of 112 age- and sex-matched controls (p < 0.001). For 7 patients with both pre- and postoperative CT scans available for evaluation, the mean postoperative MI was 0.55 (SD 0.03), significantly greater than their preoperative MIs (mean 0.48 [SD 0.04], p = 0.001) and comparable to the mean MI of the controls (p = 0.30). In 4 patients, clinically obtained postoperative MIs by caliper measurement were comparable to measurements derived from CT (p = 0.141). CONCLUSIONS The MI is a useful measurement of the severity of trigonocephaly in patients with metopic synostosis. This simple quantitative assessment can potentially be used in the clinical setting to guide preoperative evaluation, surgical repair, and postoperative degree of correction. SN - 1933-0715 UR - https://www.unboundmedicine.com/medline/citation/27153376/The_metopic_index:_an_anthropometric_index_for_the_quantitative_assessment_of_trigonocephaly_from_metopic_synostosis_ L2 - https://thejns.org/doi/10.3171/2016.2.PEDS15524 DB - PRIME DP - Unbound Medicine ER -