3-Dimensional surface laser scanning anthropometry of the head and hand. Accurate and quick analysis of malformations and deformations and the effect of surgical and non-invasive shape corrections

Anthropometry is essential to define craniofacial deformities, especially when correction is wanted. Traditional anthropometry collects data by using homologues body surface points (e.g. anatomical landmarks) and simple measures such as circumferences, breadths, and heights. Unfortunately this information is often insufficient to reconstruct contours. 3-Dimensional measurements however provide information on shape, volume and area and therefore allow precise analysis of body contours. Based on the Nobel Prize for Medicine awarded Computer assisted Tomography (CT)-scan slices 3-dimensional reconstruction’s were made in 1986. Nowadays this method is routine in craniofacial surgery and enables good surgical planning. Disadvantages of CT-scanning are the required radiation, time consumption, the need for anaesthesia in children and its costs. Magnetic Resonance Imaging (MRI) derived slices can also be reconstructed into 3-D images. MRI is even more time consuming, anaesthesia is required in children and the costs are high. Therefore, it is medical ethically incorrect to perform repeated CT and MRI scans. In contrast 3-dimensional anthropometry by surface laser scanning is quick (< 17 s), accurate with a higher resolution (< 1 mm) and uses harmless (near)-visible light. As a consequence, 3-dimensional imaging of children can be done without anaesthesia and repeated measurements can be performed safely. Plastic and reconstructive surgery pursues to create a normal shape of the head and neck. Therefore we are being consulted for many congenital malformations and acquired deformations in the head and neck region (e.g. craniosynostosis, hemifacial macrosomia, microtia, clefts, vascular malformations, positional moulding etc.). 3-Dimensional surface anthropometry is essential to analyse those malformations and deformations, and to study the outcome of surgical or non-invasive corrections. Non-synostotic plagiocephaly (skull deformation with open sutures) is "epidemically" seen in 10% of all new-borns since 1992, when supine position was advocated to reduce the incidence of sudden infant-death-syndrome. Correction of this deformation by helmet-therapy is controversial, because the effect of helmet-therapy can not be analysed by repeated CT or MRI 3-dimensional images. However, the requested surface laser scanner will enable us to obtain quickly accurate 3-dimensional images without any harm to patients and their controls and opens the possibility of longitudinal evaluation. Craniofacial treatment modalities can now be analysed, which would be impossible without this surface laser scanner. Initially we will use the surface laser scanner to support research on the effectivity of helmet therapy in non-synostotic plagiocephaly. In addition, the 3-dimensional images could enable the producer of the remodellation helmets to manufacture the helmet by CAD-CAM technology in stead of pure manual production. Analysis of treatment of other craniofacial abnormalities will follow, such as teeth and jaw position (from plaster models), cleft lip/alveolus and/or palate, craniosynostosis (abnormal cranial vault shape due to premature closure of cranial sutures) and its surgical correction, Pierre Robin sequence (underdevelopment of the lower jaw) and bone-distraction, hemifacial macrosomia (underdevelopment of half a face) and tissue augmentation. Analysis of hand deformities will be a next project. Anatomy and surgical correction of congenital and acquired defects will be established, e.g. position of a newly reconstructed thumb in severe hypoplasia or position of newly created webs in syndactyly. In conclusion 3-dimensional surface laser scanning anthropometry opens new doors to unriddle unanswered questions by its accurate, quick, harmless and longitudinal way of analysing human structures during growth.