Browsing by Author "Barnes, Courtney"

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Trigonocephaly in a select South African population: A morphometric analysis utilising specific anatomical cranial landmarks.
(2024) Barnes, Courtney; Lazarus, Lelika.; Madaree, Anil.
Trigonocephaly is a congenital abnormality that is caused by the premature fusion of the metopic suture. A triangular shaped forehead, shortening of the anterior cranial fossa (ACF), hypotelorism, narrowing of the bitemporal region, and widening of the occipitoparietal region are some of the cranial and facial deformities that patients with trigonocephaly present with. Literature on the morphometry of the ACF and cranial base is scarce in patients with trigonocephaly; most studies focus on the morphometric changes that occur to the entire cranium rather than the cranial base. Therefore, this study aimed to investigate the morphometric changes that occurred to the ACF and orbits in trigonocephaly patients and to determine whether compensatory growth of the middle and posterior cranial fossae (MCF and PCF) was evident via volumetric assessment. Additionally, the identification of various cranial parameters in order to assess the severity of patients with trigonocephaly remains controversial. Thus, this study also aimed to describe an improved grading system in the assessment of trigonocephaly within a select South African population. Dimensions of the ACF and of the orbits, and volumetric assessment of all three cranial fossae were measured using specific anatomical cranial landmarks on preoperative computed tomography (CT) scans of 15 patients with a radiographic confirmed diagnosis of non-syndromic, isolated trigonocephaly between 2012 and 2023, and eight non-affected age-matched pediatric patients were selected as the control group. ACF dimensions in younger and trigonocephaly patients who were classified as severe, were observed to be larger compared to control patients, whilst in older and trigonocephaly patients who were classified as severe, ACF dimensions were observed to be smaller compared to control patients. MCF volume showed significance (p=0.050), whilst ACF and PCF volumes, respectively showed no significance (p=0.170 and p=0.821) when trigonocephaly patients were compared to controls. Additionally, maximum compensatory growth occurred in the PCF compared to the MCF in trigonocephaly patients. The overall dimensions of the orbit showed no significance between trigonocephaly and control patients. However, significant findings were observed in the correlation analysis between the interorbital distance and other orbital parameters and ACF angles when trigonocephaly patients were compared to control patients. Furthermore, more complex orbital morphologies were observed in trigonocephaly patients in younger age groups, compared to less complex orbital morphologies which were observed in older age groups. This study provides novel morphometric and morphological data within a specific South African population. The data obtained could further assist craniofacial surgeons by providing a relationship between the degree of severity and choice of surgical intervention. Additionally, the orbital data obtained could indicate to surgeons the morphological changes that occur in the orbits, and provide an insight into the evolution of the deformity in pediatric patients with trigonocephaly in order to obtain as near to normal orbital features.