Calvarial Resurfacing for the Surgical Management of Ossified Cephalohematoma Using Computer-assisted Planning and 3 Dimensional-printed Guides.

Cephalohematoma, a common complication of birth trauma, typically resolves spontaneously within the first month of life. However, in rare cases, these hematomas ossify, presenting unique challenges in management and treatment. Ossification likely occurs through mechanisms involving osteogenic progenitor cells and cytokines within the hematoma, leading to subperiosteal bone formation. Clinical evaluation and diagnostic imaging are critical for identifying and classifying ossified cephalohematomas (OCs) to guide surgical decision-making. Recent advancements in craniofacial surgery, including computer-assisted planning (CAP), have enhanced precision in managing these cases. We present 2 cases of type 1 OCs in pediatric patients who underwent successful surgical correction using CAP. Digital imaging and communications in medicine files from computed tomography scans were used to create 3-dimensional anatomical models, enabling detailed preoperative planning. Custom surgical guides were designed and fabricated to ensure precise reshaping depth and restoration of cranial contours. Reconstruction involved removal of ossified tissue with depth-matched contouring to the contralateral skull. Postoperative outcomes showed significant improvement in cranial shape, with no complications observed at the 6-month follow-up. This report highlighted the utility of CAP in optimizing surgical accuracy, reducing operative time, and enhancing aesthetic and functional outcomes. By enabling preoperative planning and execution, CAP can minimize intraoperative variability and improve the overall success of OC management. These findings underscore the importance of integrating advanced surgical technologies to address the challenges associated with OCs.