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Semin Plast Surg 2024; 38(03): 214-223
DOI: 10.1055/s-0044-1786803
Review Article

Application of Computerized Surgical Planning in Craniosynostosis Surgery

Neil Parikh   *
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
,
Ali Aral   *
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
,
Katelyn Lewis
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
,
Michael Alperovich
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
› Author Affiliations Funding M.A. receives funding from CTSA Grant Number KL2 TR001862 from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH) and consults for Johnson & Johnson and LifeNet Health. The manuscript contents are solely the responsibility of the authors and do not necessarily represent the official view of the NIH. The other authors have no financial interests to declare in relation to the content of this article.
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Abstract

Craniosynostosis, a medical condition characterized by premature fusion of one or multiple cranial sutures, has historically been treated through surgical correction. Computerized Surgical Planning (CSP) and three-dimensional (3D) modeling have gained significant popularity across craniofacial surgery. Through a collaborative effort between surgeons and engineers, it is now possible to virtually execute a surgical plan based on preoperative imaging using computed tomography scans. The CSP workflow involves several elements including virtual 3D modeling, CSP computer-aided surgical guide design, manufacturing of guides and templates, and intraoperative implementation. Through the gradual optimization of this workflow, it has been possible to achieve significant progress in the surgical process including improvements in the preoperative planning of complex craniosynostosis cases and reduction of intraoperative time. Furthermore, CSP and 3D modeling have had a positive impact on surgical simulation and residency training, along with patient education and counseling. This article summarizes the CSP workflow in the treatment of craniosynostosis and the implications of this treatment modality on medical trainee education and patient management.

Keywords

normative pediatric skull model - resorbable plating - overcorrection

* Co-first authors.




Publication History

Article published online:
13 May 2024

© 2024. Thieme. All rights reserved.

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  • References

  • 1 Johnson D, Wilkie AO. Craniosynostosis. Eur J Hum Genet 2011; 19 (04) 369-376
    CrossrefPubMedGoogle Scholar
  • 2 Blessing M, Gallagher ER. Epidemiology, genetics, and pathophysiology of craniosynostosis. Oral Maxillofac Surg Clin North Am 2022; 34 (03) 341-352
    CrossrefPubMedGoogle Scholar
  • 3 Tarnow P, Kölby L, Maltese G. et al. Incidence of non-syndromic and syndromic craniosynostosis in Sweden. J Craniofac Surg 2022; 33 (05) 1517-1520
    CrossrefPubMedGoogle Scholar
  • 4 Lee HQ, Hutson JM, Wray AC. et al. Changing epidemiology of nonsyndromic craniosynostosis and revisiting the risk factors. J Craniofac Surg 2012; 23 (05) 1245-1251
    CrossrefPubMedGoogle Scholar
  • 5 Shlobin NA, Baticulon RE, Ortega CA. et al. Global epidemiology of craniosynostosis: a systematic review and meta-analysis. World Neurosurg 2022; 164: 413-423.e3
    CrossrefPubMedGoogle Scholar
  • 6 Junaid M, Slack-Smith L, Wong K. et al. Epidemiology of rare craniofacial anomalies: retrospective Western Australian population data linkage study. J Pediatr 2022; 241: 162-172.e9
    CrossrefPubMedGoogle Scholar
  • 7 Kalmar CL. et al. Changes in intracranial pressure with craniosynostosis based on age at intervention, syndromic status, and multiple suture involvement. Plast Reconstr Surg Glob Open 2020; 8 (9, suppl): 24
    CrossrefPubMedGoogle Scholar
  • 8 Czerwinski M, Kolar JC, Fearon JA. Complex craniosynostosis. Plast Reconstr Surg 2011; 128 (04) 955-961
    CrossrefPubMedGoogle Scholar
  • 9 Tibesar RJ, Scott AR. Syndromic craniofacial disorders. Facial Plast Surg Clin North Am 2024; 32 (01) 141-156
    CrossrefPubMedGoogle Scholar
  • 10 Wang JC, Nagy L, Demke JC. Syndromic craniosynostosis. Facial Plast Surg Clin North Am 2016; 24 (04) 531-543
    CrossrefPubMedGoogle Scholar
  • 11 Steinbacher DM. Three-dimensional analysis and surgical planning in craniomaxillofacial surgery. J Oral Maxillofac Surg 2015; 73 (12, suppl): S40-S56
    CrossrefPubMedGoogle Scholar
  • 12 Recker MJ, Barber JC, Xia JJ. et al. Accuracy of surgical outcome using computer-aided surgical simulation in fronto-orbital advancement for craniosynostosis: a pilot study. Oper Neurosurg (Hagerstown) 2024; 26 (01) 46-53
    CrossrefPubMedGoogle Scholar
  • 13 Efanov JI, Roy AA, Huang KN, Borsuk DE. Virtual surgical planning: the pearls and pitfalls. Plast Reconstr Surg Glob Open 2018; 6 (01) e1443
    CrossrefPubMedGoogle Scholar
  • 14 Farrell BB, Franco PB, Tucker MR. Virtual surgical planning in orthognathic surgery. Oral Maxillofac Surg Clin North Am 2014; 26 (04) 459-473
    CrossrefPubMedGoogle Scholar
  • 15 Chim H, Wetjen N, Mardini S. Virtual surgical planning in craniofacial surgery. Semin Plast Surg 2014; 28 (03) 150-158
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Mardini S, Alsubaie S, Cayci C, Chim H, Wetjen N. Three-dimensional preoperative virtual planning and template use for surgical correction of craniosynostosis. J Plast Reconstr Aesthet Surg 2014; 67 (03) 336-343
    CrossrefPubMedGoogle Scholar
  • 17 Gray R, Gougoutas A, Nguyen V, Taylor J, Bastidas N. Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population. Int J Pediatr Otorhinolaryngol 2017; 97: 163-169
    CrossrefPubMedGoogle Scholar
  • 18 Zhao L, Patel PK, Cohen M. Application of virtual surgical planning with computer assisted design and manufacturing technology to cranio-maxillofacial surgery. Arch Plast Surg 2012; 39 (04) 309-316
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Fisher M, Medina III M, Bojovic B, Ahn E, Dorafshar AH. Indications for computer-aided design and manufacturing in congenital craniofacial reconstruction. Craniomaxillofac Trauma Reconstr 2016; 9 (03) 235-241
    CrossrefPubMedGoogle Scholar
  • 20 Andrew TW, Baylan J, Mittermiller PA. et al. Virtual surgical planning decreases operative time for isolated single suture and multi-suture craniosynostosis repair. Plast Reconstr Surg Glob Open 2018; 6 (12) e2038
    CrossrefPubMedGoogle Scholar
  • 21 Mendez BM, Chiodo MV, Patel PA. Customized “in-office” three-dimensional printing for virtual surgical planning in craniofacial surgery. J Craniofac Surg 2015; 26 (05) 1584-1586
    CrossrefPubMedGoogle Scholar
  • 22 Ostaș D, Almășan O, Ileșan RR. et al. Point-of-care virtual surgical planning and 3d printing in oral and cranio-maxillofacial surgery: a narrative review. J Clin Med 2022; 11 (22) 6625
    CrossrefPubMedGoogle Scholar
  • 23 Long AS, Gudbranson E, Almeida MN. et al. Utilizing computer-assisted design and virtual surgical planning for correction of unilateral lambdoid synostosis. J Craniofac Surg 2023; 34 (03) 1036-1038
    CrossrefPubMedGoogle Scholar
  • 24 Almeida MN, Alper DP, Williams MCG. et al. Virtual surgical planning in craniosynostosis reduces operative time and length of stay for cranial vault remodeling. J Craniofac Surg 2023; 34 (07) 1931-1933
    CrossrefPubMedGoogle Scholar
  • 25 Ganesh P, Mahipathy SRRV, Rajan VTT. et al. Traditional versus virtual surgery planning of the fronto-orbital unit in anterior cranial vault remodeling surgery. J Craniofac Surg 2021; 32 (01) 285-289
    CrossrefPubMedGoogle Scholar
  • 26 Eastwood KW, Bodani VP, Haji FA, Looi T, Naguib HE, Drake JM. Development of synthetic simulators for endoscope-assisted repair of metopic and sagittal craniosynostosis. J Neurosurg Pediatr 2018; 22 (02) 128-136
    CrossrefPubMedGoogle Scholar
  • 27 Cheng D, Yuan M, Perera I. et al. Developing a 3D composite training model for cranial remodeling. J Neurosurg Pediatr 2019; 24 (06) 632-641
    CrossrefPubMedGoogle Scholar
  • 28 Lobb DC, Cottler P, Dart D, Black JS. The use of patient-specific three-dimensional printed surgical models enhances plastic surgery resident education in craniofacial surgery. J Craniofac Surg 2019; 30 (02) 339-341
    CrossrefPubMedGoogle Scholar
  • 29 Alshomer F, AlFaqeeh F, Alariefy M, Altweijri I, Alhumsi T. Low-cost desktop-based three-dimensional-printed patient-specific craniofacial models in surgical counseling, consent taking, and education of parent of craniosynostosis patients: a comparison with conventional visual explanation modalities. J Craniofac Surg 2019; 30 (06) 1652-1656
    CrossrefPubMedGoogle Scholar
  • 30 Chen J, Kumar S, Shallal C. et al. Caregiver preferences for three-dimensional printed or augmented reality craniosynostosis skull models: a cross-sectional survey. J Craniofac Surg 2022; 33 (01) 151-155
    CrossrefPubMedGoogle Scholar