3D Analysis of the Cranial and Facial Shape in Craniosynostosis Patients: A Systematic Review

Abstract

With increasing interest in 3D photogrammetry, diverse methods have been developed for craniofacial shape analysis in craniosynostosis patients. This review provides an overview of these methods and offers recommendations for future studies. A systematic literature search was used to identify publications on 3D photogrammetry analyses in craniosynostosis patients until August 2023. Inclusion criteria were original research reporting on 3D photogrammetry analyses in patients with craniosynostosis and written in English. Sixty-three publications that had reproducible methods for measuring cranial, forehead, or facial shape were included in the systematic review. Cranial shape changes were commonly assessed using heat maps and curvature analyses. Publications assessing the forehead utilized volumetric measurements, angles, ratios, and mirroring techniques. Mirroring techniques were frequently used to determine facial asymmetry. Although 3D photogrammetry shows promise, methods vary widely between standardized and less conventional measurements. A standardized protocol for the selection and documentation of landmarks, planes, and measurements across the cranium, forehead, and face is essential for consistent clinical and research applications.

FIGURE 1

PRISMA diagram.

FIGURE 2

Base planes with corresponding landmarks 2.1. Opistocranion—lower orbital 2.2. Sella turcica/dorsum sella—nasion/sellion 2.3. Tragus—lateral canthus 2.4. Preaurale—nasion/sellion 2.5. Porion—lower orbital 2.6. Tragus—subnasale 2.7. Tragus—nasion/sellion.

FIGURE 3

Forehead measurements. 3.1. Frontal prominence in angles; 3.2. Forehead volume; 3.3. Frontal angle and Frontoparietal angle; 3.4. Frontal angle and frontal width. Ns/Se, nasion/sellion; Gl, glabella; Pr, prenasale; CrH, crus helix; FTPl/ZFl, frontotemporal point left/zygomaticofrontal left; PA, parietal point; PrAu, preaurale; FA30, Frontal angle 30; A/B/C/D/E, corresponding to Rodriguez-Florez.