Pediatric Neurosurgery
Technical Note
Use of a 3D Skull Model to Improve Accuracy in Cranioplasty for Autologous Flap Resorption in a 3-Year-Old ChildMaduri R.a · Viaroli E.a · Levivier M.a, b · Daniel R.T.a, b · Messerer M.aaDepartment of Clinical Neurosciences, Service of Neurosurgery, University Hospital of Lausanne (CHUV), and bFaculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Article / Publication Details
Received: March 27, 2017
Accepted: July 07, 2017
Published online: August 19, 2017
Issue release date: September 2017
Number of Print Pages: 5
Number of Figures: 4
Number of Tables: 0
ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)
For additional information: https://www.karger.com/PNE
Abstract
Cranioplasty is considered a simple reconstructive procedure, usually performed in a single stage. In some clinical conditions, such as in children with multifocal flap osteolysis, it could represent a surgical challenge. In these patients, the partially resorbed autologous flap should be removed and replaced with a precustomed prosthesis which should perfectly match the expected bone defect. We describe the technique used for a navigated cranioplasty in a 3-year-old child with multifocal autologous flap osteolysis. We decided to perform a cranioplasty using a custom-made hydroxyapatite porous ceramic flap. The prosthesis was produced with an epoxy resin 3D skull model of the patient, which included a removable flap corresponding to the planned cranioplasty. Preoperatively, a CT scan of the 3D skull model was performed without the removable flap. The CT scan images of the 3D skull model were merged with the preoperative 3D CT scan of the patient and navigated during the cranioplasty to define with precision the cranioplasty margins. After removal of the autologous resorbed flap, the hydroxyapatite prosthesis matched perfectly with the skull defect. The anatomical result was excellent. Thus, the implementation of cranioplasty with image merge navigation of a 3D skull model may improve cranioplasty accuracy, allowing precise anatomic reconstruction in complex skull defect cases.
© 2017 S. Karger AG, Basel
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Article / Publication Details
Received: March 27, 2017
Accepted: July 07, 2017
Published online: August 19, 2017
Issue release date: September 2017
Number of Print Pages: 5
Number of Figures: 4
Number of Tables: 0
ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)
For additional information: https://www.karger.com/PNE
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