Background:
Craniosynostosis correction surgery is a complex procedure, which involves complete dismantling and reassembly of the cranial vault components. The traditional planning method for these surgeries results in increased intra-operative time owing to its highly subjective nature. The advent of virtual surgical planning (VSP) platform has lead to a greater pre-operative insight and precision outcome in calvarial remodeling surgeries. The purpose of this paper is to evaluate intra-operative time and blood loss difference as a measure of surgical efficiency between VSP based template guided Anterior Cranial Vault Reconstruction (ACVR) with Fronto-Orbital Unit Advancement (FOUA) and the traditional surgeries.
Methods:
Data were collected from patients who underwent ACVR with FOUA in our unit. Patients were divided into 2 groups, Template Fronto-Orbital Unit (TFOU) group and Non-template Fronto-Orbital Unit (NFOU) group. In TFOU group, Virtual planning along with fabrication of Template guide was carried out. Patients undergoing ACVR using traditional techniques were categorized as NFOU group. A comparative prospective analysis was carried out in terms of Intra-operative time duration and blood loss. Student ‘t’ test was used to compare the means of the 2 groups.
Results:
A total of 10 patients were included in the present study. There were 5 control (NFOU) and 5 TFOU cases. There was a significant decrease in the operating time in TFOU group compared to the NFOU group. TFOU group also showed reduced intra-operative bleed compared to the NFOU group.
Conclusion:
Virtual surgical planning (VSP) and 3D modeling with prefabricated template guide augurs reliable outcomes and portends the possibility of lesser intra-operative time. It is a valuable tool, which offers enormous benefits in terms of precise pre-surgical planning with predictive results.
Background: The coronal incision with its various modifications provides the most versatile approach to various areas in the craniomaxillofacial region coupled with excellent exposure. The aesthetic advantage of a hidden scar in the hairline, accounts for its continued popularity. In maxillofacial it can be used for fractures in the frontal bone, nasal bone and extensive fractures involving zygomatic arch and complex
Methods:In this clinical and observational study, we operated 5 patients with complex cranio-maxillofacial injuries involving frontal bone, zygomatic arch and zygomatic complex, nasal bone and supra-orbital region. All the five cases were trauma cases between ages of 20 to 60 years with no facial nerve injury per-operatively. These cases for followed for post-operative complications namely sensory and motor nerve deficits, haematoma, wound dehiscence and ptosis Result: Two patients each had sensory and motor nerve deficits and one patient had minimal wound dehiscence, all settled conservatively
Conclusion:The incision provides excellent access, has reduced complications and produces an acceptable scar. This incision is advised in treating complex cranio-facial trauma, tumors and le-fort esthetic surgeries.
Frontal bone fractures are rare and occur in only 5-12% of maxillofacial traumas and have a relatively low incidence if compared to the remaining types of fracture involving the cranio-maxillofacial region. The fact that the frontal bone is more protected from traumatic events by both the prominence of the nasal pyramid which protects the naso-orbital region and the frontal bone higher resistance to mechanical impacts could attribute to this.
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