Craniofacial Dysmorphology in Unilateral Coronal Synostosis Using Three-Dimensional Landmark-Based Analysis With Generalized Procrustes Superimposition

John W. Rutland, Bradley N. Delman, Christopher Bellaire, James G. Napoli, William Shuman, Emily A. Rutland, Daniel Ranti, Ilana G. Margulies, Pedram Goel, Farah Sayegh, Mark M. Urata, Peter J. Taub

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background:Geometric morphometric analysis with Procrustes superimposition is an advanced computational tool that can be used to quantify dynamic changes in complex three-dimensional structures. The present study couples high resolution CT imaging with a Geometric Morphometric approach in order to further understand the complex dysmorphology that occurs in unilateral coronal synostosis (UCS).Methods:Forty-one UCS patients and 41 age- and sex-matched controls received high-resolution CT imaging. Thirty-one anatomical landmarks were identified on each imaging set. A geometric morphometric workflow was used to perform a Procrustes superimposition to register landmarks into a common space. Procrustes-aligned landmarks were used to derive angle calculations, lengths, and other anatomical measurements. Three-dimensional coordinates were also used to perform a principal components analysis (PCA).Results:Unilateral coronal synostosis patients exhibited significant angular deviation at the levels of the inferior skull base, mid-posterior fossa, and vertex. Both left- and right-sided UCS patients showed increased lengthening in the transverse (left-right) dimension, exhibiting increased length between the left and right EAC (P = 0.047). Conversely, UCS patients revealed shortening in the midline AP dimension as evidenced by the decreased Nasal root-Lambda (P < 0.0001) and Nasal root-superior dorsum sellae (P = 0.01) distances compared with controls. PCA revealed that 25.26% of variation in shape among the patients sampled to be driven by flattening of the skull and that18.93% of variation was driven by right-sided deformity and mediolateral expansion.Conclusions:Significant dysmorphology between UCS patients and controls was quantified using Geometric Morphometric approach, which may be useful in further characterizing the dynamic craniofacial changes in UCS.

Original languageEnglish
Pages (from-to)16-20
Number of pages5
JournalJournal of Craniofacial Surgery
Issue number1
StatePublished - 1 Jan 2021


  • Craniofacial reconstruction
  • geometric morphometrics
  • procrustes superimposition
  • sphenotemporal deformity
  • unilateral coronal synostosis


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