Computer-assisted virtual planning and surgical template fabrication for frontoorbital advancement

Soleman, Jehuda; Thieringer, Florian M.; Beinemann, Jörg; Kunz, Christoph; Guzman, Raphael

doi:10.3171/2015.3.focus14852

Cited by 56 publications

(36 citation statements)

References 29 publications

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“…Neurosurgeons have used 3D printed surgical templates for fronto-orbital advancement surgery (136), which they found to be accurate, easy to use, efficient, and reproducible.…”

Section: Surgical Instrumentation and Guidesmentioning

confidence: 99%

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

et al. 2016

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Three dimensional (3D) printing involves a number of additive manufacturing techniques that are used to build structures from the ground up. This technology has been adapted to a wide range of surgical applications at an impressive rate. It has been used to print patient-specific anatomic models, implants, prosthetics, external fixators, splints, surgical instrumentation, and surgical cutting guides. The profound utility of this technology in surgery explains the exponential growth. It is important to learn how 3D printing has been used in surgery and how to potentially apply this technology. PubMed was searched for studies that addressed the clinical application of 3D printing in all surgical fields, yielding 442 results. Data was manually extracted from the 168 included studies. We found an exponential increase in studies addressing surgical applications for 3D printing since 2011, with the largest growth in craniofacial, oromaxillofacial, and cardiothoracic specialties. The pertinent considerations for getting started with 3D printing were identified and are discussed, including, software, printing techniques, printing materials, sterilization of printing materials, and cost and time requirements. Also, the diverse and increasing applications of 3D printing were recorded and are discussed. There is large array of potential applications for 3D printing. Decreasing cost and increasing ease of use are making this technology more available. Incorporating 3D printing into a surgical practice can be a rewarding process that yields impressive results.

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“…Neurosurgeons have used 3D printed surgical templates for fronto-orbital advancement surgery (136), which they found to be accurate, easy to use, efficient, and reproducible.…”

Section: Surgical Instrumentation and Guidesmentioning

confidence: 99%

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

et al. 2016

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“…In recent years, computer-assisted analysis of 3D medical image data has been employed to improve the head shape description [ 9 – 12 ] and to aid in the diagnosis of craniosynostosis [ 13 – 19 ] as well as in the evaluation of surgical outcomes [ 20 – 23 ]. With the aim of facilitating cranio-maxillofacial surgery, statistical shape modelling (SSM) has been used in virtual surgery planning [ 24 – 28 ] as well as in the design of pre-fabricated templates [ 29 – 31 ], surgical guides [ 32 , 33 ] and cranial implants [ 34 , 35 ] to achieve desired patient-specific post-operative outcomes on-table. However, some craniofacial procedures rely on gradual post-operative skull remodelling instead of acute changes and thus seek to obtain desired shapes not immediately on the operative table, but months later.…”

Section: Introductionmentioning

confidence: 99%

Statistical shape modelling to aid surgical planning: associations between surgical parameters and head shapes following spring-assisted cranioplasty

et al. 2017

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PurposeSpring-assisted cranioplasty is performed to correct the long and narrow head shape of children with sagittal synostosis. Such corrective surgery involves osteotomies and the placement of spring-like distractors, which gradually expand to widen the skull until removal about 4 months later. Due to its dynamic nature, associations between surgical parameters and post-operative 3D head shape features are difficult to comprehend. The current study aimed at applying population-based statistical shape modelling to gain insight into how the choice of surgical parameters such as craniotomy size and spring positioning affects post-surgical head shape.MethodsTwenty consecutive patients with sagittal synostosis who underwent spring-assisted cranioplasty at Great Ormond Street Hospital for Children (London, UK) were prospectively recruited. Using a nonparametric statistical modelling technique based on mathematical currents, a 3D head shape template was computed from surface head scans of sagittal patients after spring removal. Partial least squares (PLS) regression was employed to quantify and visualise trends of localised head shape changes associated with the surgical parameters recorded during spring insertion: anterior–posterior and lateral craniotomy dimensions, anterior spring position and distance between anterior and posterior springs.ResultsBivariate correlations between surgical parameters and corresponding PLS shape vectors demonstrated that anterior–posterior (Pearson’s ) and lateral craniotomy dimensions (Spearman’s ), as well as the position of the anterior spring () and the distance between both springs () on average had significant effects on head shapes at the time of spring removal. Such effects were visualised on 3D models.ConclusionsPopulation-based analysis of 3D post-operative medical images via computational statistical modelling tools allowed for detection of novel associations between surgical parameters and head shape features achieved following spring-assisted cranioplasty. The techniques described here could be extended to other cranio-maxillofacial procedures in order to assess post-operative outcomes and ultimately facilitate surgical decision making.

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“…The design methods for the reconstruction of the cranio-maxillofacial defects are as follows. After printing the skull model of the pre-operative form, pre-bending of the plate, fabrication of an onlay template by model surgery, or fabrication of the implant on the skull model [ 44 – 48 ] After performing virtual surgery, including resection and reconstruction in the pre-operative image, printing of a resection guide or fabrication of the template by printing the skull model with virtual surgery [ 49 , 50 ] After printing of the skull model reconstructed symmetrically using a mirror image of the unaffected side, pre-bending of the plate, using it as a template, or fabrication of the implant directly on the skull model [ 51 – 53 ] After reconstruction symmetrically using a mirror image of the unaffected side and design of the 3D implant to fit precisely to the defect, fabrication of the PSI by transferring the PSI data to CAM software [ 3 , 8 , 32 , 54 – 57 ] …”

Section: Reviewmentioning

confidence: 99%

“…After performing virtual surgery, including resection and reconstruction in the pre-operative image, printing of a resection guide or fabrication of the template by printing the skull model with virtual surgery [ 49 , 50 ]…”

Section: Reviewmentioning

confidence: 99%

Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing

2018

Maxillofac Plast Reconstr Surg

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With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.

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Computer-assisted virtual planning and surgical template fabrication for frontoorbital advancement

Cited by 56 publications

References 29 publications

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

Surgical applications of three-dimensional printing: a review of the current literature & how to get started

Statistical shape modelling to aid surgical planning: associations between surgical parameters and head shapes following spring-assisted cranioplasty

Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing

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