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Normalcranialevolution432DISCUSSIONInthisstudythenormalgrowthofthecraniumduringthefirstyearsoflifewasevaluated extensivelyusing3Dstereophotogrammetry and3D-CT.Early detectioniskeyinendoscopicallyassistedcraniosynostosissurgeryandnormativereferencedatacouldbeusedforadequateandearlydetectionofabnormalities211Inadditionthesereferencedatacouldbeusedbyclinicalexpertstomakefollowupassessmentduringremodellinghelmettherapymoreobjective213Alsothedataprovideareferenceforpreoperativeplanningofopenreconstructivecraniosynostosissurgeryin whicha virtualreconstructionof thenewcranialshapeandvolumeismade14Thereforethisstudyaddressestheneedfornormativecranialevolutiondatafordetectionfollow-upandplanningincraniosynostosisConsistentwiththeliteraturethegrowthmapsofthe3DphotographsandCT-HTrevealedrapidexpansionofthecraniumintheyoungeragegroups1915Between3and6monthsastrongfocusofgrowthwasfoundtobelocatedinthefrontalregionandinthecentralparietalregionsindicatingthegrowthkernelsThelocationsofthesagittalandcoronalsutureswereclearlyindicatedbythecoloursofthegrowthmapsemphasizingtheimportanceofsuturesforgrowthofthecranium1617Thefocusofgrowthinthe12–24monthsgrowthmapwaslocatedintheoccipitalheadregionclosetothesiteofthecerebellumThetimingofthecerebellumvolumeincreasecorrespondswiththetimingofinfantsstartingtowalkanddeveloptheirbalanceandmusclecoordinationfunctionsAlthoughtherelationshipbetweenbrainfunctionalityandvolumeisnotclear,brainvolumemightinfluencebraindevelopmentandthismightbeanexplanationforthevolumeincreaseinthisregion18Usingmagneticresonanceimaging(MRI)dataadisproportionateenlargementofthecerebellumduringthefirst2yearswasdescribedbyKnickmeyeretalalthoughthisenlargementwasevenmoreprominentinthefirstyear19Inthe12–24monthsintervalthe3Dphotographsdemonstrated3–4mmmorefrontalgrowthcomparedtotheCT-HTgroupPopulationandagedifferencesaswellasmoreandlongerhairmighthaveresultedinagreatervolumeatthebackofthehead ThislargerposteriorvolumecouldresultinamoreposteriorlylocatedCCFP.Consequentlythiswouldleadtoamoreanterioralignmentofthecranialshapesandthuserroneouslydemonstratemorefrontalgrowth
