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Computer assisted virtual planning and surgical templates manufacturing in craniosynostosis surgery

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COMPUTER ASSISTED VIRTUAL PLANNING AND SURGICAL TEMPLATES MANUFACTURING IN CRANIOSYNOSTOSIS SURGERY 

INTRODUCTION AND AIM

vAchieving the best aesthetic outcome using frontoorbital remodeling to treat craniosynostosis involving coronal and metopic sutures is complex and challenging.

v Computer assisted virtual planning and individualized surgical templates manufacturing is a useful tool for optimizing surgical results.

vWe describe our results using this technique since 2016.

 

METHODS

vA virtual working model was generated using a 3D cranial CT scan obtained preoperatively.

v  Frontoorbital remodeling virtual planning was carried out by simulating the osteotomies in the orbital bandeau and the frontal bones to achieve the desired configuration.

v This process was performed through a close collaboration between medical and engineering teams (Fig 1).

v Then the cutting guides and negative and positive stereolitography (SLI) templates were manufactured and used in the remodeling during surgical procedure.

v  Bone fragments were fixed with resorbable material (poli- D, L -lactic mesh, plates and pins) using ultrasound technique.

 

RESULTS

vEight patients underwent surgery for correction of trigonocephaly (6 patients) and anterior plagiocephaly (2 patients) between November 2016 and February 2018.

vThe medium age at the time of surgery was 9 months. Average surgical time: 275´. Preoperative planification time: 120´.

vBoth intra- and postoperative results were satisfactory. No surgery complications occurred to date.

 

CONCLUSION

Virtual planning and computed assisted SLA templates modeling have been shown to be interesting and advantageous tools for the successful treatment of craniofacial deformities that may be considered.

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