Article
Modelling guides for craniosynostosis surgery and follow-up by 3D photography –"Cutting guides" produced on CT-data have been introduced to craniosynostosis surgery in recent years. The aim of this study is to evaluate the accuracy and practicability of "modelling guides" through 3D photography.
Modeling guides in der Kraniosynostosenchirurgie –"Cutting guides" wurden anhand von CT-Daten in den letzten Jahren in die Kraniosynostosen-Chirurgie eingeführt. Ziel der vorliegenden Studie ist es, die Genauigkeit und Praktikabilität von "modeling guides" durch 3D-Fotographie zu evaluieren.
Search Medline for
Authors
-
J. Camilo Roldán
- Katholisches Kinderkrankenhaus Wilhelmstift Hamburg, Plastische Kindergesichtschirurgie und Gesichtsfehlbildungschirurgie, Hamburg, Deutschland
-
Jan Gliemroth
- Universitätsklinikum Schleswig-Holstein, Klinik für Neurochirurgie, Lübeck, Deutschland
| Published: | June 26, 2020 |
|---|
Outline
Text
Objective: Despite efforts to avoid ionizing radiation, the so-called "cutting guides" for cranioplasty in craniosynostosis, based on CT data, have been propagated in recent years. The aim of the present study is to evaluate the feasibility and accuracy of the planning and implementation of "modeling guides" for cranioplasty in craniosynostosis surgery by using 3D photography.
Methods: Since 2014, 50 craniosynostosis operations have been performed. One week before surgery a 3D photography was taken (Canfield, New Jersey, USA). The patient photography was overlaid with normal heads at the same age in order to define ideal profile (sagittal plane) and width (axial plane). Standard osteotomies were performed. Osteosynthesis took place by resorbable plates (Sonic-Weld, KLS-Martin, Tuttlingen, Germany). 3-D images were taken 4 weeks, 2 and 6 months postoperatively, and then annually up to 5 years. The result was rated as: 1 very good; 2 good; 3 satisfactory; 4 bad.
Results: Six months after surgery the result was stable as anticipated by the modeling guides (scale 1-2). One year after surgery a slightly deterioration was observed (scale 2-3): Trigonocephaly (n=20): Narrowing of the fronto-basal angle. Outcome improved through vertical releasing osteotomies of the frontal segment (n=17). Scaphocephaly (n=17): Narrowing of the posterior cranial width. The elimination of plates for lateral stabilization (n=8) improved outcome. Plagiocephaly (n = 6): 90° transposition of the ipsilateral frontal bone (n=1) improve outcome (1). Lambdoid synostosis (n = 2): Bone flap transposition right-to-left (n = 1) improved result (1). Brachycephalus (n = 5): The result was good and remained constant.
Conclusion: The modeling guides created by 3D photography showed to be practicable, accurate, reproducible and cost effective. The long-term outcome does not correlate with the immediate result. Changes in skull shape correlates with the placement of releasing modeling osteotomies and the intrinsic expansion of brain lobes.
