Skull reconstruction planning transfer to the operation room by thin metallic templates: clinical results.
BACKGROUND
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.


METHODS
This study applies an automated filter procedure, implemented in Matlab, 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 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.


CONCLUSIONS
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.
Clijmans
Tim
T
Division of Biomechanics and Engineering Design, Katholieke Universiteit Leuven, Leuven, Belgium. tim.clijmans@mech.kuleuven.be
Mommaerts
Maurice
M
Gelaude
Frederik
F
Suetens
Paul
P
Sloten
Jos Vander
JV
D000535:Aluminum; D002508:Cephalometry; D003198:Computer Simulation; D003398:Craniosynostoses / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D007223:Infant; D008953:Models, Anatomic; D010347:Patient Care Planning; D015203:Reproducibility of Results; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D013526:Surgical Mesh; D014057:Tomography, X-Ray Computed
D000535:Aluminum