Journal
JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY
Volume 36, Issue 2, Pages 66-74Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jcms.2007.08.003
Keywords
craniosynostoses; skull; craniotomy; computer-aided design; patient care planning; computer-assisted surgery
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Introduction: Craniofacial malformations implicate a risk of medical complications and a negative psychological impact on the patient. In order to correct functional and aesthetic aspects of these malformations, skull reconstruction is required. Because of the complexity of the surgery, pre-operative planning is unavoidable. Current and previously developed planning environments often lack the opportunity to transfer the simulated surgery to the operation room on a cheap but accurate, and easy to handle basis. Materials and methods: This study applies an automated filter procedure, implemented in Matlab (R), to generate a set of adapted contours from which a surface mesh can be directly deduced. Skull reconstruction planning is performed on the generated outer bone surface model. For each resected/osteotomized bone part, the presented semi-automatic Matlab (R) procedure generates surface based bone cutting guides, also denoted bone segment templates. Autoclaved aluminium templates transfer the surgical plan to the operation room. Results: The clinical feasibility is demonstrated by the successful pre-operative planning and surgical correction of three skull reconstruction cases in which the proposed procedure leads to considerable reduction in surgery time and good results. Conclusion: A cost-efficient and planning-environment-independent solution is generated for an accurate and fast transfer of a complex cranial surgery plan to the operation room. (C) 2007 European Association for Cranio-Maxillofacial Surgery.
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