title: Three-dimensional surgical planning and simulation to improve surgical accuracy and reduce invasiveness of cranioplasties.
abstract: Patients with too large a frontal prominence may suffer discomfort and subsequent self-esteem problems. The case of a 29-year-old male with a prominent forehead is presented. After three-dimensional (3D) virtual simulation of the procedure, a stereolithographic model of the skull and a surgical cutting guide were fabricated. The forehead recontouring and reconstruction procedure was performed under general anaesthesia and the postoperative course was uneventful. At the 12-month postoperative follow-up, clinical and radiographic documentation confirmed softening of the frontal prominence from 14.48mm to 8.56mm, a nasofrontal angle increase of 22°, and overall high patient satisfaction. The proposed workflow results in greater surgical precision, shorter reconstruction times, reduced patient morbidity due to a reduced risk of dural exposure and postoperative infection, and overall higher predictability and patient satisfaction.
authors.affiliation: Institute of Maxillofacial Surgery, Teknon Medical Centre, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain. Electronic address: avalls@institutomaxilofacial.com.
authors.forename: A
authors.initials: A
authors.lastname: Valls-Ontañón
authors.affiliation: Institute of Maxillofacial Surgery, Teknon Medical Centre, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Mezquida-Fernández
authors.affiliation: Institute of Maxillofacial Surgery, Teknon Medical Centre, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Guijarro-Martínez
authors.affiliation: Institute of Maxillofacial Surgery, Teknon Medical Centre, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Hernández-Alfaro
mesh_terms: D000328:Adult; D054893:Cone-Beam Computed Tomography; D004954:Esthetics; D005546:Forehead / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D010347:Patient Care Planning; D019651:Plastic Surgery Procedures / Q000379:methods*; D012886:Skull / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: aesthetic surgery; cone beam computed tomography; cranioplasty; feminization; forehead; frontal bone; frontal sinus; surgical cutting guide; surgical planning software