Department of Mechanical Engineering, University College London, London, UK.
Department of Maxillofacial Surgery and Plastic Surgery, School of Medicine, Necker - Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France.
Sci Rep. 2021 Oct 27;11(1):21216. doi: 10.1038/s41598-021-00642-7.
Sagittal synostosis is the most occurring form of craniosynostosis, resulting in calvarial deformation and possible long-term neurocognitive deficits. Several surgical techniques have been developed to correct these issues. Debates as to the most optimal approach are still ongoing. Finite element method is a computational tool that's shown to assist with the management of craniosynostosis. The aim of this study was to compare and predict the outcomes of three reconstruction methods for sagittal craniosynostosis. Here, a generic finite element model was developed based on a patient at 4 months of age and was virtually reconstructed under all three different techniques. Calvarial growth was simulated to predict the skull morphology and the impact of different reconstruction techniques on the brain growth up to 60 months of age. Predicted morphology was then compared with in vivo and literature data. Our results show a promising resemblance to morphological outcomes at follow up. Morphological characteristics between considered techniques were also captured in our predictions. Pressure outcomes across the brain highlight the potential impact that different techniques have on growth. This study lays the foundation for further investigation into additional reconstructive techniques for sagittal synostosis with the long-term vision of optimizing the management of craniosynostosis.
矢状缝早闭是颅缝早闭中最常见的形式，导致颅骨变形和可能的长期神经认知缺陷。已经开发出几种手术技术来纠正这些问题。关于最理想方法的争论仍在继续。有限元方法是一种计算工具，已被证明有助于颅缝早闭的管理。本研究旨在比较和预测三种矢状缝颅缝早闭重建方法的结果。在这里，基于一名 4 个月大的患者开发了一个通用的有限元模型，并在所有三种不同的技术下进行了虚拟重建。模拟颅骨生长以预测颅骨形态以及不同重建技术对大脑生长的影响，直至 60 个月大。然后将预测的形态与体内和文献数据进行比较。我们的结果与随访时的形态学结果具有很好的相似性。我们的预测也捕捉到了考虑中的技术之间的形态特征。整个大脑的压力结果突出了不同技术对生长的潜在影响。这项研究为进一步研究矢状缝早闭的其他重建技术奠定了基础，以期优化颅缝早闭的管理。
