Application of Virtual Planning and Three-Dimensional Printing Guide in Surgical Management of Craniosynostosis

Abstract

This study aims to elaborate on the application of virtual surgical planning (VSP) and 3-dimensional printing guides (3DP) in the surgical management of craniosynostosis and compare their surgical outcomes with traditional surgical planning (TSP). A retrospective review of patients who underwent cranial vault and cranio-orbital remodeling procedures for craniosynostosis was performed. VSP was accomplished by establishing a 3D model from DICOM format CT data. Patients' skull shape were adjusted according to the age-matched standard skull, cutting and reconstruction guides were printed using a 3D printer. The change of anthropometric cranial indices, the so-called degree of correction, before and after the operation was evaluated to assess the surgical outcome. The TSP group serves as the historical control group, and surgical outcomes were compared among propensity-matched patients in the VSP+3DP group. In total, 120 patients with various presentations of craniosynostosis were operated on from 2005 to 2024, and 77 received surgery with VSP+3DP. There were 35 matched pairs. Both had 17 male patients with similar age and body weight. A greater degree of correction was achieved in the VSP+3DP group (9.75% vs. 6.36%, P value=0.016) with less intraoperative blood loss (144.57 mL vs. 296.86 mL, P value<0.001), shorter operation time (335.23 minutes vs. 348.34 minutes, P value=0.501), and hospital stay (10.31 days vs. 12.63 days, P value=0.009). With virtual surgical planning and 3D printing guides, precise preoperative planning, efficient intra-operative correction of cranial deformity, and objective surgical outcome assessment are achieved in craniosynostosis operations.