Anthropometric Study of Facial Morphology in Northern Thai Population Aged 1 to 18 Years Old to Inform the Timing of Craniofacial Reconstruction

Objective: To determine normal range of craniofacial structures, compare between male and female and establish growth curves in subjects aged 4 to 18 years old. Moreover, to determine normal range of craniofacial structures in subpopulation aged 1 to 3 years old. Materials and Methods: The present study was a cross-sectional study including 388 healthy subjects consisted of 363 subjects aged 4 to 18 years old and 25 subjects aged 1 to 3 years old. Both groups were Northern Thai. All subjects were measured to record the craniofacial anthropometry and established the growth curves in 6 regions including head, face, orbit, nose, labio-oral and ears. Results: In the population aged 4 to 18 years old, upper vermillion height of males was 9.03±2.92 mm. while in females was 8.45±2.38 mm (p=0.039). Left auricular length of males was 57.22±5.33 mm, while in females was 55.89±4.59 mm (p=0.011). Right auricular length of males was 57.40±5.35 mm, while in females was 55.91±4.75 mm (p=0.006). In the population aged 1 to 3 years old, left palpebral fissure of male was 10.42±2.45 mm, while in females was 8.27±1.43 mm (p=0.041). The trend in morphological face height was stable after 13 years old. The trend in physiognomical face height, binocular width, mouth width, and auricular height was stable after 16 years old. The trend in forehead height, mandible width, and nasolabial angle was stable after 18 years old. Conclusion: Each of the parameters showed a tendency to be stable at a specific cut-off age. Therefore, craniofacial reconstruction should be carried out after the specific cut-off ages identified in the results. Keywords: Facial anthropometry; Anthropometrics; Craniofacial; Northern Thai

Craniofacial Reconstruction via Face Elevation Map Estimation Based on the Deep Convolution Neutral Network

In this study, to achieve the possibility of predicting face by skull automatically, we propose a craniofacial reconstruction method based on the end-to-end deep convolutional neural network. Three-dimensional volume data are obtained from 1447 head CT scans of Chinese people of different ages. The facial and skull surface data are projected onto two-dimensional space to generate a two-dimensional elevation map, and then, use the deep convolution neural network to realize the prediction of skull to face shape in two-dimensional space. The encoder and decoder are composed of first feature extraction through the encoder and then as the input of the decoder to generate the craniofacial restoration image. In order to accurately describe the features of different scales, we adopt an U-shaped codec structure with cross-layer connections. Therefore, the output features are decomposed with the features of the corresponding scales in the encoding stage to achieve the integration of different scales while restoring the feature scales in the compression and decoding stage. Meanwhile, the U-net structures help to avoid the problem of loss of detail features in the downsampling process. We use supervised learning to obtain the prediction model from skull to facial elevation map. Back-projection operation is performed afterwards to generate facial surface data in 3D space. Experiments show that the proposed method in this study can effectively achieve craniofacial reconstruction, and for most part of the face, restoration error is controlled within 2 mm.

Open craniofacial reconstruction for coronal craniosynostosis

Here the authors demonstrate open craniofacial reconstruction for the correction of craniosynostosis, using techniques refined by Dr. James T. Goodrich at Montefiore Medical Center. They present the operative management of a case of unilateral coronal synostosis in a 12-month-old child, who presented with right forehead prominence and calvarial asymmetry. The patient had an excellent correction of her head shape with an uneventful postoperative course. This video highlights the authors’ multidisciplinary approach to complete cranial vault remodeling, utilizing a Marchac bandeau construct and split calvarial graft mosaic technique. The video can be found here: https://vimeo.com/519489422.