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56Chapter3trigonocephalypatientssuffering fromisolatednon-syndromicprematureclosureofrespectivelythesagittalorthemetopicsutureDiagnosiswasconfirmedusingacomputedtomography(CT)scanThepre-operative3Dphotographsofthescaphocephalypatients were taken at an average ageof 41months(range29–51months)andthe3Dphotographsofthetrigonocephalypatientsatanaverageageof 40months(range30–51months)A totalof603Dphotographsofhealthycontrolswereincludedintheagerangeof3–6monthsAllcontrolsubjectswerewithoutknownassociatedanomaliesThestudyprotocolwasapprovedbythemedicalethicalcommissionoftheinstitutioninwhichthestudywascarriedout17934filenumberNL1793409107Table1LandmarkpositionsLandmarkpositionsPretragion(leftandright)Externalcantion(leftandright)Internalcantion(leftandright)NasalbridgeSubnasallandmarkatthetransitionofthenoseandupperlipDATAACQUISITIONThree-dimensionalstereophotogrammetry(3dMDCranial3DMDAtlantaUSA)witha five-podconfiguration wasused forimageacquisition The3DphotographsofallsubjectswereacquiredbyatrainedphotographerIncasethereflectionofhaircausedartefactsonthe3DphotographthesubjectswerephotographedwithatightnylonskullcapAll3DphotographsofthepatientswereacquiredonedaypriortosurgerySeverequalityinconsistencyintheacquired3DphotographswasanexclusioncriterionFigure11Overviewofthethree-dimensional(3D)superimpositionmethod(A)3Dphotographwithtexture Theredpointsindicatethelandmarkpositionsaccordingto Table1(B)LandmarksandcomputedcranialfocalpointmethodusedforsuperpositionofthecranialshapesReferenceplaneswereusedforalignment(C) Topviewofthefinalregistrationandscalingofthecranialshapes