Software-assisted bone thickness evaluation in patients with syndromic craniosynostosis undergoing Le Fort III osteotomy: a technical note.

The aim of this study was to assess the value of the use of software for the preoperative evaluation of cranial bone thickness in syndromic patients undergoing Le Fort III osteotomy. Four patients were evaluated preoperatively to determine whether they were eligible for distraction osteogenesis. Data from the computed tomography scans was evaluated using advanced reverse engineering tools to determine the temporal bone thickness. Three patients showed adequate values for the positioning of a rigid external distractor device (average thickness values >3.5 mm), while one patient showed insufficient bone thickness (average value <2.5 mm) and therefore underwent midface advancement according to the traditional technique. Adequate midface advancement was obtained in the three patients who underwent distraction osteogenesis. No complications related to the rigid external distractor were observed. A shorter skeletal advancement was obtained in the patient who underwent Le Fort III osteotomy according to the traditional technique. A cerebrospinal fluid fistula was observed after the removal of the plates, requiring surgical repair. Software evaluation of the cranial bone thickness is a useful tool in the surgical planning of Le Fort III osteotomy in patients affected by syndromic craniosynostosis.