The volumetric change of cranial cavity in the patients with craniosynostosis after fronto-orbital advancement

Abstract

Objective To assess the surgical outcome of fronto-orbital advancement (FOA)in the patients with craniosynostosis by quantitative analysis of the cranial volume using the three-dimensional digital technology. Methods From January 2010 to February 2016, 10 cases of craniosynostosis were included in the study. The average age of patients was 3.2 years (1 year old to 6.5 years old). All patients underwent modified FOA.Based on the uncompressed digital imaging and communications in medicine (DICOM) data of 3D cranial CT scan, the intracranial volume was measured by Proplan CMF 1.4.The average follow-up time was 23.6 months. We quantitatively analysed brain volume in ten patients with craniosynostosis, comparing with the normal data of age- and sex-matched healthy controls. Paired t tests were performed to compare mean value of the variables. Results The volume of intracranial cavity was(1 117.39 ± 105.83) ml before surgery and the preoperative volume of intracranial cavity in the control group was (1 251.37 ± 114.35) ml. The difference between the preoperative group and the preoperative control group was statistically significant(P=0.00030). The volume of intracranial cavity was (1 260.84 ± 122.08) ml after surgery. The volume was increased significantly after surgery(P=0.00002). There was no significant difference between the postoperative group and the preoperative control group(P=0.60000). The volume of intracranial cavity was (1 368.65 ± 94) ml at least one year follow-up and the cranial volume of the control group was (1 321.96 ± 80.21) ml. There was no statistically significant difference between the two groups(P=0.07000). There were statistically significant differences between the cranial volume at two weeks after operation and that of one year follow-up (P=0.00300). This result showed that the cranial vault and brain of patients grew and developed normally after FOA surgery. Conclusions Preoperative cerebral volume in the patients with craniosynostosis was lower than normal. The cranial volume has been effectively expanded and basically reached the normal level after fronto-orbital advancement. Especially, the intracranial volume maintained normal during follow-up. Key words: Craniosynostosis; Fronto-orbital advancement; Intracranial volume; Digitization