Orbital volume, ophthalmic sequelae and severity in unilateral coronal synostosis

Sophia A J Kronig,Otto D M Kronig,Léon N A Van Adrichem,Marcel Zurek

doi:10.1007/s00381-021-05065-3

Sophia A J Kronig, Otto D M Kronig + Show 2 more

Open Access

https://doi.org/10.1007/s00381-021-05065-3

Copy DOI

Abstract

PurposeUnilateral coronal synostosis (UCS) results in an asymmetrical skull, including shallow and asymmetrical orbits, associated with reduced orbital volume and high prevalences of ophthalmic sequelae. Aim is to link orbital volumes in patients with UCS to severity according to UCSQ (Utrecht Cranial Shape Quantifier) and presence of ophthalmic sequelae.MethodsWe included preoperative patients with UCS (≤ 18 months). Orbital volume was measured on CT scans by manual segmentation (Mimics software (Materialise, Leuven, Belgium)), and severity of UCS was determined by UCSQ. Orbital volume of affected side was compared to unaffected side using Wilcoxon signed rank test. Orbital volume ratio was calculated (affected/unaffected volume) and compared to the category of UCSQ by Kruskal-Wallis test. Opthalmic sequelae were noted.ResultsWe included 19 patients (mean age 7 months). Orbital volume on affected side was significantly lower (p = 0.001), mean orbital volume ratio was 0.93 (SD 0.03). No significant differences in group means of orbital volume ratio between different levels of severity of UCSQ were found (Kruskal-Wallis H (2) = 0.873; p > 0.05). Ophthalmic sequelae were found in 3 patients; one had adduction impairment and strabismus (mild UCS), one had astigmatism (moderate UCS), and one had abduction impairment (on both ipsi- and contralateral side) and vertical strabismus (severe UCS).ConclusionNo association between orbital volume ratio and severity of UCS was found. Side-to-side asymmetry in orbital volume was noted. No association between either preoperative orbital volume ratio or severity of UCS and the presence of preoperative ophthalmic sequelae was found.

Highlights

IntroductionIn patients with Unilateral coronal synostosis (UCS), high prevalences of ophthalmic problems are found, which are thought to be secondary to the anatomical deformities in the orbit on the ipsilateral side, and the resulting orbital asymmetry may underlie visual abnormalities [2, 21, 31]
Unilateral coronal synostosis (UCS) or anterior plagiocephaly is a result of synostosis of a unilateralin patients with UCS, high prevalences of ophthalmic problems are found, which are thought to be secondary to the anatomical deformities in the orbit on the ipsilateral side, and the resulting orbital asymmetry may underlie visual abnormalities [2, 21, 31]
Aim of the present study was to link calculated orbital volumes in preoperative patients with UCS to the degree of severity according to UCSQ and the presence of ophthalmic sequelae

Summary

Introduction

In patients with UCS, high prevalences of ophthalmic problems are found, which are thought to be secondary to the anatomical deformities in the orbit on the ipsilateral side, and the resulting orbital asymmetry may underlie visual abnormalities [2, 21, 31] These ophthalmic sequelae include impairment of eye movement, strabismus, amblyopia, astigmatism and visual field defects, and may occur on both the ipsi- and contralateral side of the synostosis [2, 5,6,7, 12, 14, 21,22,23, 31]. UCSQ is proven to be suited for quantification of severity of UCS by using two characteristic variables: asymmetry ratio of frontal peak and ratio of frontal peak gradient [18]

Objectives

Methods

Conclusion