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Cranialshapeevaluation553INTRODUCTIONCraniosynostosisisacongenitaldefectthatcausesoneormoresuturesofthenewborn’sskull toossifyprematurelyAsaresultnormalskullgrowthisimpededinthedirectionperpendiculartotheaffectedsuturesresultinginabnormalcranialmorphologyInadditiontoabnormalskullgrowthcraniosynostosiscanresultincomplicationssuchasintracranialhypertensionvisualimpairmentandlimitationofbraingrowth1–3 Topreventorresolvethesecomplicationssurgicaltreatmentisrequired TodayavarietyofsurgicaltreatmentoptionsareavailableThemostcommonlyusedtypesofsurgeryforpatientswithasingle-suturecraniosynostosisincludecranial vaultremodellingspring-mediatedcranioplastyandendoscopicallyassistedstripcraniectomyfollowedbyremoldinghelmettherapy45BecausethereisstillalackofapropervalidatedmethodtoevaluatethecranialvaultofcraniosynostosispatientsandtoestablishanobjectivequantificationoftheseverityoftheabnormalitythereisnoconsensusonwhichofthetreatmentoptionsprovidesthebestlongtermfunctionalandaestheticoutcomeThereforethefollow-upofcraniosynostosistreatmentandfinallythedeterminationoftheoptimalsurgicalprocedureremainsarathersubjectivematter6–8Three-dimensional(3D)stereophotogrammetryisafastandpatient-friendlymethodtoevaluatethecomplete3DmorphologyofthecranialshapeBecausenopotentiallyharmfulionizingradiationisrequired3Dstereophotogrammetryisanidealtechniquetoacquirea3Dimageofthecranialshapefordiagnosisandduringfollow-upTheaimofthisstudywastopresentanewmethodfortheobjectiveevaluationofthe3Dmorphologyofthecranialshape3DphotographsofahealthycontrolgroupwereusedtoestablishthenormalcranialshapeanditsvariationsScaphocephalyandtrigonocephalypatientswerecomparedwiththecontrolsandprincipalcomponentanalysis(PCA)wasusedtotestiftherewasasignificantdifferencebetweenthegroupsPATIENTSANDMETHODSSUBJECTSAtotalof1003Dstereophotographswereincludedinthisprospectivestudy Thisdatasetincluded203Dphotographsofpatientswithscaphocephalyand203DphotographsofpatientswithtrigonocephalyTheincludedscaphocephalyand