Soleman Jehuda, Thieringer Florian, Beinemann Joerg, Kunz Christoph, Guzman Raphael
Department of Neurosurgery, Division of Pediatric Neurosurgery, and.
Neurosurg Focus. 2015 May;38(5):E5. doi: 10.3171/2015.3.FOCUS14852.
OBJECT The authors describe a novel technique using computer-assisted design (CAD) and computed-assisted manufacturing (CAM) for the fabrication of individualized 3D printed surgical templates for frontoorbital advancement surgery. METHODS Two patients underwent frontoorbital advancement surgery for unilateral coronal synostosis. Virtual surgical planning (SurgiCase-CMF, version 5.0, Materialise) was done by virtual mirroring techniques and superposition of an age-matched normative 3D pediatric skull model. Based on these measurements, surgical templates were fabricated using a 3D printer. Bifrontal craniotomy and the osteotomies for the orbital bandeau were performed based on the sterilized 3D templates. The remodeling was then done placing the bone plates within the negative 3D templates and fixing them using absorbable poly-dl-lactic acid plates and screws. RESULTS Both patients exhibited a satisfying head shape postoperatively and at follow-up. No surgery-related complications occurred. The cutting and positioning of the 3D surgical templates proved to be very accurate and easy to use as well as reproducible and efficient. CONCLUSIONS Computer-assisted virtual planning and 3D template fabrication for frontoorbital advancement surgery leads to reconstructions based on standardizedmeasurements, precludes subjective remodeling, and seems to be overall safe and feasible. A larger series of patients with long-term follow-up is needed for further evaluation of this novel technique.
目的 作者描述了一种使用计算机辅助设计（CAD）和计算机辅助制造（CAM）技术制造个性化3D打印手术模板用于额眶前移手术的新技术。方法 两名患者因单侧冠状缝早闭接受额眶前移手术。通过虚拟镜像技术和年龄匹配的标准化3D儿童颅骨模型叠加进行虚拟手术规划（SurgiCase-CMF，版本5.0，Materialise公司）。基于这些测量结果，使用3D打印机制造手术模板。根据消毒后的3D模板进行双额开颅和眶带截骨术。然后通过将骨板放置在负性3D模板内并用可吸收聚-dl-乳酸板和螺钉固定来完成重塑。结果 两名患者术后及随访时头部形状均令人满意。未发生与手术相关的并发症。3D手术模板的切割和定位被证明非常准确、易于使用且可重复且高效。结论 用于额眶前移手术的计算机辅助虚拟规划和3D模板制造可实现基于标准化测量的重建，避免主观重塑，且总体看来安全可行。需要对更多患者进行长期随访以进一步评估这项新技术。
