Three-dimensional printing of a sinus pericranii model: technical note

Simonin, Alexandre; Martinerie, Sébastien; Levivier, Marc; Daniel, Roy Thomas

doi:10.1007/s00381-017-3357-6

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…While others have used 3D printing for evaluation of sinus pericranii and for pre-operative planning 29,30 and even to evaluate dehiscence of the sigmoid sinus cortical plate in pulsatile tinnitus patients 31 , ours are the first 3D printed models of the dural venous sinuses to show not only sound generation but also the effects of lumbar puncture in patients with IIH. The main limitation of this work is the limited number of subjects.…”

Section: Resultsmentioning

confidence: 99%

Sound Measurement in Patient-Specific 3D Printed Bench Models of Venous Pulsatile Tinnitus

Valluru¹,

Parkhill²,

Gautam³

et al. 2020

Otology &Amp; Neurotology

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Hypothesis:We hypothesize patient-specific flow models to be an adequate in vitro surrogate to allow for characterization of Pulsatile Tinnitus that affects 3-5 million Americans.Background: Pulsatile tinnitus (PT), rhythmic sounds without an extracorporeal source that patients appreciate, can be caused by aberrant blood flow in large cerebral veins near the cochlea. In order to investigate the sound production mechanism, we created 3D printed flow models based on patient-specific cerebral venous anatomies.Methods: Magnetic resonance angiography datasets from two patients with PT were used to generate patient-specific 3D printed flow models. A flow circuit connecting the patient-specific models to a pulsatile, continuous flow pump simulating cardiac cycle was created. Sound recordings were made along the surface of the models using an electronic stethoscope. Peak-torms amplitude, and area under the power spectral density (PSD) curve values were computed to evaluate the sound measurements. Wilcoxon rank sum test was used to statistically determine the differences in measurements between the patient-specific models. Results:In patient-1, the recordings (peak-to-rms) from the internal jugular vein stenosis of baseline model (4.29±1.26 for 146 samples) were significantly louder (p<0.001) than that of the altered model (3.29±0.96 for 143 samples). In patient-2, the sound measured at the transverse sinus stenosis in the pre-lumbar puncture model (4.84±1.11 for 148 samples) was significantly louder (p<0.0001) than that of the post-lumbar puncture model (3.14±0.87 for 135 samples). Conclusions:The models are able to generate sounds very similar to those appreciated by patients and examiners in the cases of objective PT.

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Section: Resultsmentioning

confidence: 99%

Sound Measurement in Patient-Specific 3D Printed Bench Models of Venous Pulsatile Tinnitus

Valluru¹,

Parkhill²,

Gautam³

et al. 2020

Otology &Amp; Neurotology

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“…MRV cannot demonstrate SP when the venous flow in SP is not sufficient [3, 12], thereby suggesting that MRV in our patient may have indicated a slow enough blood flow in the SP. In addition, the indication of DSA seems to be controversial because of the possible risk related to the procedure, and the unnecessity of DSA in a case of SP with patent intracranial sinuses on MRI has been reported [13]. Interestingly, the SP in our case was partially thrombosed.…”

Section: Discussionmentioning

confidence: 78%

A Simple Surgical Technique for Pediatric Sinus Pericranii: Intraoperative Manual Compression of a Major Shunting Point

et al. 2021

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Introduction: Sinus pericranii is a vascular anomaly with extra- and intracranial venous connections. Sinus pericranii is categorized into 2 groups according to its contribution to the normal venous circulation. The accessory type sinus pericranii, which does not contribute to the normal major venous circulation, can be managed. Despite several proposed operative maneuvers, a standardized technique is yet to be established to control intraoperative bleeding. Case Presentation: A 2-week-old neonate underwent examination of a subcutaneous mass in the parieto-occipital region. The subcutaneous mass had a major venous connection to the superior sagittal sinus on ultrasonography. The subcutaneous mass was partially thrombolized on magnetic resonance imaging and was minimally enhanced on computed tomography venography. The subcutaneous mass seemed not to contribute to the normal venous circulation. Surgical removal of the subcutaneous mass was performed due to its increased size at the age of 1 year and 3 months. While subcutaneous mass was detached from the scalp, the major venous connection was manually compressed, and minor venous connections were easily detected. The intraoperative bleeding was controllable. The pathological diagnosis was sinus pericranii. The patient is now followed up in the outpatient clinic. No recurrence was seen 18 months after the surgery. Discussion/Conclusion: Intraoperative hemostasis is essential while sinus pericranii is detached from the cranium. Hemostatic agents such as bone wax or absorbable gelatin and heat coagulation seem to be useful. However, complicative hemorrhage concerning to the preceded technique has been also reported. As seen in our case, to detect minor shunting points between the sinus pericranii and the intracranial veins, the major venous connection was manually compressed. Intraoperative manual compression of a major venous connection of sinus pericranii can be an option to manage intraoperative bleeding.

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“…17,18 Moreover, for confirming the intracranial communication with the dural sinus, digital subtraction angiography (DSA) is the gold standard which can detect SP location, size, and the blood flow dynamics. 19,20 MRI can demonstrate SP position and differentiation from other scalp vascular anomalies. [21][22][23] Comparatively, 3D reconstruction with enhanced cranial CT can clearly depict fused sutures, shape of skull defect, location and size of SP, and abnormal intracranial communication with the dural sinus.…”

Section: Discussionmentioning

confidence: 99%

“…The ultrasonography is always the first-line screening tool to disclose the subcutaneous vascular mass 17,18 . Moreover, for confirming the intracranial communication with the dural sinus, digital subtraction angiography (DSA) is the gold standard which can detect SP location, size, and the blood flow dynamics 19,20 . MRI can demonstrate SP position and differentiation from other scalp vascular anomalies 21–23 .…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Sinus Pericranii With Crouzon Syndrome

Han

Cui

et al. 2020

Journal of Craniofacial Surgery

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Background: Sinus pericranii (SP) is a rare vascular malformation which connects the intracranial dural sinuses to the extracranial venous drainage system. Although the majority of SP cases are caused by trauma, some of them are congenital. Furthermore, a few SP cases have been reported in association with craniosynostosis. The authors' objective is to discuss the surgical management of SP with Crouzon's syndrome in children. Methods: Three-Dimensional reconstruction with enhanced CT scan was used for evaluate the condition of SP with Crouzon's syndrome in all 4 cases. Two cases with small single-hole defect on skull were only treated by cranioplasty with distraction osteogenesis. In the management of the other 2 SP patients with large skull defect, titanium mesh was used for compression of dilated venous sinus to inhabit filling and promote shrinking. Result: Four cases of SP with Crouzon's syndrome were treated in the authors' department. With cranioplasty with distraction osteogenesis only, 2 patients with single-hole skull defect experienced SP spontaneous involution at 4 to 6 months postoperatively. With titanium mesh compression, SP with large skull defect shrank significantly without clinical recurrence, but long-term follow-up was still in need. Conclusion: For small single-hole skull defect in SP patient with Crouzon's syndrome, the only application of cranioplasty for decreasing intracranial pressure can promote SP spontaneous involution. 3D printed titanium mesh compression renders a safe and efficient approach for SP with large skull defect. Long-time follow up and further accumulation of cases may establish the efficacy of the authors' management.

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Three-dimensional printing of a sinus pericranii model: technical note

Abstract: We report the case of a 4-month-old infant with a SP for whom we used a three-dimensional printed model in order to define the angioarchitecture, improve management, and help parents' understanding of this uncommon condition.

Cited by 7 publications

References 14 publications

Sound Measurement in Patient-Specific 3D Printed Bench Models of Venous Pulsatile Tinnitus

Sound Measurement in Patient-Specific 3D Printed Bench Models of Venous Pulsatile Tinnitus

A Simple Surgical Technique for Pediatric Sinus Pericranii: Intraoperative Manual Compression of a Major Shunting Point

Surgical Management of Sinus Pericranii With Crouzon Syndrome

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