Skip to main content

Quantitative and qualitative assessment of morphology in sagittal synostosis: mid-sagittal vector analysis.

Publication ,  Journal Article
Marcus, JR; Stokes, TH; Mukundan, S; Forrest, CR
Published in: J Craniofac Surg
July 2006

Consensus remains lacking regarding the optimal surgical treatment modality for sagittal synostosis. There is, however, wide agreement that objective analytical methods are required to demonstrate the characteristic morphology of the condition and to substantiate the benefits of specified surgical techniques. Simple calculated anthropomorphic indices, such as the cranial index, are commonly used but fail to provide satisfactory representation of morphology, which is far more complex than can be represented by its simple length-width ratio. Techniques to provide more comprehensive, yet practical, assessment of morphology are needed for analytic purposes. Herein, we introduce vector analysis as an objective, computed tomography (CT)-based morphometric technique for assessment of cranial morphology; this work represents the first application of the technique mid-sagittal vector analysis (MSVA). MSVA is a single plane application that was devised to address dysmorphology in sagittal synostosis. It was our hypothesis that MSVA would quantitatively and qualitatively depict preoperative morphology and postoperative correction in specific regions. Sixteen patients undergoing cranial reshaping surgery for sagittal synostosis were included in the study. All patients underwent routine preoperative and 1 year postoperative CT scans, from which the MSVA was derived. MSVA is a radial vector analysis in which distances to the cranial surface are measured from a single reference point origin in the sagittal plane. Preoperative morphology, characterized by respective vectors, was analyzed in three regions: the frontal, vertex, and occipital regions. Comparison with postoperative paired data was conducted for each patient. The analysis of postoperative change demonstrated (1) decrease in prominence in the frontal and occipital regions, (2) increase in height and forward translation of the vertex, and (3) ability to distinguish and qualify frontal versus occipital bossing and correction thereof. We conclude that the longitudinal differences associated with scaphocephaly are well characterized and differentiated by MSVA. Quantitative and qualitative assessment identifies three relevant regions affected by the condition and its treatment: the frontal, vertex, and occipital regions. The transverse dimension is not addressed in this single plane analysis; a more comprehensive application will require additional planes of analysis and the development of a normative database.

Duke Scholars

Published In

J Craniofac Surg

DOI

ISSN

1049-2275

Publication Date

July 2006

Volume

17

Issue

4

Start / End Page

680 / 686

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Sella Turcica
  • Parietal Bone
  • Occipital Bone
  • Nasal Bone
  • Longitudinal Studies
  • Infant
  • Humans
  • Frontal Bone
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Marcus, J. R., Stokes, T. H., Mukundan, S., & Forrest, C. R. (2006). Quantitative and qualitative assessment of morphology in sagittal synostosis: mid-sagittal vector analysis. J Craniofac Surg, 17(4), 680–686. https://doi.org/10.1097/00001665-200607000-00013
Marcus, Jeffrey R., Tracey H. Stokes, Srinivasan Mukundan, and Christopher R. Forrest. “Quantitative and qualitative assessment of morphology in sagittal synostosis: mid-sagittal vector analysis.J Craniofac Surg 17, no. 4 (July 2006): 680–86. https://doi.org/10.1097/00001665-200607000-00013.
Marcus JR, Stokes TH, Mukundan S, Forrest CR. Quantitative and qualitative assessment of morphology in sagittal synostosis: mid-sagittal vector analysis. J Craniofac Surg. 2006 Jul;17(4):680–6.
Marcus, Jeffrey R., et al. “Quantitative and qualitative assessment of morphology in sagittal synostosis: mid-sagittal vector analysis.J Craniofac Surg, vol. 17, no. 4, July 2006, pp. 680–86. Pubmed, doi:10.1097/00001665-200607000-00013.
Marcus JR, Stokes TH, Mukundan S, Forrest CR. Quantitative and qualitative assessment of morphology in sagittal synostosis: mid-sagittal vector analysis. J Craniofac Surg. 2006 Jul;17(4):680–686.

Published In

J Craniofac Surg

DOI

ISSN

1049-2275

Publication Date

July 2006

Volume

17

Issue

4

Start / End Page

680 / 686

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Sella Turcica
  • Parietal Bone
  • Occipital Bone
  • Nasal Bone
  • Longitudinal Studies
  • Infant
  • Humans
  • Frontal Bone