Orbital Anthropometrics Correct to Age-Matched Values after Strip Craniectomy in Metopic Craniosynostosis
Bibliographic record
Abstract
BACKGROUND: Children with metopic craniosynostosis have distinct orbital dysmorphologies that include perceived hypotelorism and a symmetric, elliptical orbital aperture canted toward the synostosed suture. The extent to which hypotelorism is a true skeletal difference or, rather, perceived hypotelorism in the setting of trigonocephaly has been previously debated (1). Additionally, maneuvers to address the intercanthal distance during traditional fronto-orbital advancement procedures yield inconsistent results on orbital anthropometrics. The purpose of this study is to expand on our previous work by detailing pre- and post-operative orbital anthropometrics among a cohort of metopic synostosis patients undergoing endoscopic strip craniectomy (ESC) compared to age-matched controls. We aim to (1) detail the presence/absence of true skeletal hypotelorism in young infants with metopic synostosis and (2) define the role of ESC in restoring orbital anthropometric parameters to normal values. METHODS: A retrospective, cohort study was performed at a single center over a three-year (2020 – 2023) period. Using Slicer software, a three-dimensional craniometric analysis was performed on preoperative and one-year postoperative CT images of children with metopic craniosynostosis and age-matched peers. Twelve craniometric parameters were obtained. Age-matched children with normocephalic head shapes who underwent CT scan for other reasons than to rule-out craniosynostosis were utilized for comparison. RESULTS: Nine children were included as subjects in the study and fourteen children were included as controls. The mean age of subjects at pre-operative CT scan was 69.3 days and 72.3 days for controls. The mean age of subjects at post-operative CT scan was 14.8 months and 14.3 months for controls, for a mean follow-up of 11.4 months after ESC. 64 orbits were analyzed. Pre-operative subject Dacryon to Dacryon (Da-Da) measurements showed a significant difference from controls (12.2 ± 0.54 millimeters v. 15.4 ± 0.53 millimeters; p=0.0007), while post-surgery, there was no significant difference (16.11 ± 0.67 millimeters v. 15.10 ± 0.50 mm; p=0.2392). Similarly, Zygomaticofrontal suture to Zygomaticofrontal suture (ZF-ZF) measurements revealed a significant pre-operative difference (61.3 ±1.25 millimeters v. 67.2 ± 2.38 millimeters; p=0.0238) with post-operative normalization (76.0 ± 1.22 millimeters v. 76.0 ± 1.19 millimeters; p=0.9767). The supraorbital notch to anterior nasal spine to supraorbital notch (SON-ANS-SON) angle also indicated significant pre-operative differences (39.9 ± 0.96 degrees v. 60.1 ± 3.06 degrees; p=0.0001), with post-operative measurements showing no significant difference from controls (49.6 ± 1.39 degrees v. 55.3 ± 2.00 degrees; p=0.0674). CONCLUSIONS: Previous work demonstrated improvement in interdacryon distance before and after endoscopic strip craniectomy. The present effort shows that orbital hypotelorism in young infants with metopic synostosis is a true skeletal difference from age-matched controls that corrects after endoscopic strip craniectomy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".