Abstract
Craniosynostosis must often be corrected using surgery, by which the affected bone tissue is remodeled. Nowadays, surgical reconstruction relies mostly on the subjective judgement of the surgeon to best restore normal skull shape, since remodeled bone is manually placed and fixed. Slight variations can compromise the cosmetic outcome. The objective of this study was to describe and evaluate a novel workflow for patient-specific correction of craniosynostosis based on intraoperative navigation and 3D printing. The workflow was followed in five patients with craniosynostosis. Virtual surgical planning was performed, and patient-specific cutting guides and templates were designed and manufactured. These guides and templates were used to control osteotomies and bone remodeling. An intraoperative navigation system based on optical tracking made it possible to follow preoperative virtual planning in the operating room through real-time positioning and 3D visualization. Navigation accuracy was estimated using intraoperative surface scanning as the gold-standard. An average error of 0.62 mm and 0.64 mm was obtained in the remodeled frontal region and supraorbital bar, respectively. Intraoperative navigation is an accurate and reproducible technique for correction of craniosynostosis that enables optimal translation of the preoperative plan to the operating room.
Highlights
Craniosynostosis is a congenital defect that is defined as the premature fusion of one or more cranial vault sutures[1]
Diagnosis and surgical correction of craniosynostosis rely mostly on the subjective judgement of the surgeon, who determines the degree of the deformity and the approach to remodeling the affected bone to best restore normal skull shape
We propose a new workflow for surgical correction of craniosynostosis based on intraoperative navigation and patient-specific 3D printed guides and templates
Summary
Craniosynostosis is a congenital defect that is defined as the premature fusion of one or more cranial vault sutures[1]. Craniosynostosis can be classified in terms of the affected sutures and the resulting malformation as follows: sagittal (scaphocephaly), metopic (trigonocephaly), coronal (anterior plagiocephaly), and lambdoid (posterior plagiocephaly)[6] These morphological abnormalities may have functional consequences, such as elevated intracranial pressure and impaired brain growth[7]. Diagnosis and surgical correction of craniosynostosis rely mostly on the subjective judgement of the surgeon, who determines the degree of the deformity and the approach to remodeling the affected bone to best restore normal skull shape. This approach usually increases the duration of surgery and is highly dependent on the experience of the surgeon. Slight positional or rotational variations in the location of the bone can compromise symmetry, harmony, and balance between the face and the cranial vault and, the cosmetic outcome
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
