The turricephaly index: A validated method for recording turricephaly and its natural history in Apert syndrome

Abstract Introduction We present the CT scan-derived turricephaly index (TI) as a quotient of the maximal occipito-frontal length of the skull to the distance from the centre of the sella to the highest point on the vertex as a validated tool for assessing turricephaly and evaluating surgical techniques aimed at reducing it. Materials and methods Measurements taken from CTs of non-operated children with Apert syndrome and age-matched controls were analysed using Centricity PACS system (from the lateral scout image) and the thick-sliced Osirix tool. CTs from non-operated children with Apert syndrome were used to investigate the natural history of their turricephaly both as a group and individually. Results There was statistically significant agreement between measurements taken from the CT scout and Osirix for 42 control children (R 2  = 0.97) and 42 children with Apert syndrome (R 2  = 0.98) and between two separate observers. There was a statistically significant difference (p  2) CT's showed a similar decrease in turricephaly in the individual child (p  Conclusions TI derived from the CT scout view provides a simple, objective and validated method for assessing turricephaly. We recommend it for monitoring and for the prospective evaluation of reconstructive techniques in children with complex/syndromic craniosynostosis.