Artikel
Interdisciplinary approach for cranioplasty in children with non-syndromic craniosynostosis treated with application of modern 3D-modelling techniques and endoscopy assisted surgery
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Autoren
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D. Larysz
- Division of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Poland
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W. Wolański
- Department of Applied Mechanics, Silesian University of Technology, Gliwice, Poland
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P. Larysz
- Division of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Poland
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M. Gzik
- Department of Applied Mechanics, Silesian University of Technology, Gliwice, Poland
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M. Mandera
- Division of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Poland
| Veröffentlicht: | 28. April 2011 |
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Gliederung
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Objective: Craniosynostosis (CSO) is one of the most frequent congenital anomalies affecting head shape. CSO refers to premature fusion of one or more cranial sutures. Closure of a single suture does not only cause restriction of growth perpendicular to the fused suture, but it also causes compensatory growth at adjacent sutures. Therefore, even single suture closure affects the growth of the entire skull. The only treatment of CSO is surgical cranioplasty. In this paper we are presenting research supporting neurosurgical correction of pediatric skull defects caused by non-syndromic CSO. The authors will present cases of children with CSO showing preoperative planning with engineer support and modern 3D-modelling techniques which are crucial in custom treatment with the application of endoscopy-assisted cranioplasty.
Methods: On the basis of computer tomography (CT examinations) 3D models were created with the application of Mimics ver. 14.0, Materialise software. Detailed analysis of geometry and anatomy of the skull was performed. The models were transformed to FEM and used to determine a suitable shape. The geometrical models were presented in 3-dimensional virtual reality. Autologous bone defect reconstructions were planned with the application of 3-Matic, Materialise software. Postoperative CT examination provided assessment of the applied technique.
Results: 20 children under 4 months of age with non-syndromic craniosynostosis (trigonocephaly and scaphocephaly) were treated in Division of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Poland using endoscopy-assisted cranioplasty without postoperative helmet orthesis. Preoperative planning was performed according to the aforementioned engineering support. In all cases, we obtained a good correction of the skull shape not only in the short postoperative period but also after the follow-up of two years.
Conclusions: Preoperative planning using the 3D-modelling techniques and endoscopy-assisted cranioplasty seems to be an effective method of less invasive than standard cranioplasty treatment of children with non-syndromic CSO.
