Optimizing Craniofacial Osteotomies: Applications of Haptic and Rapid Prototyping Technology

Frame-based cranial reconstruction

“…Preliminary results of the application of a databank- 11,19 have since been confirmed by other authors, proposing fragmentary 3D shape models [2][3][4]7,[13][14][15]17 with a majority focusing on the fronto-orbital band as the key region of reshaping. To date, only Burge et al 2,17 have incorporated our approach of the intraoperative use of a customized databank-derived statistical model.…”

Rapid prototyping in craniofacial surgery: Using a positioning guide after zygomatic osteotomy – A case report

“…In addition accurate location of these segments can be difficult because of scarring and distortion of the surrounding and overlying tissues. As a result the surgeon may not achieve a satisfactory aesthetic or functional outcome (Murray et al, 2008;Marmulla and Niederdellmann, 1999;Watzinger et al, 1997;Marmulla and Niederdellmann, 1998;Klug et al, 2006;Becelli et al, 2002). In order to achieve as good an outcome as possible prior to the availability of repositioning guides such as we have described it has been necessary to use a coronal flap to expose the contralateral (normal) side for direct comparison and enable symmetrical reduction by direct view.…”

“…The ability to transform CT data into three-dimensional models using stereolithography models (Kernan and Wimsatt, 2000;Murray et al, 2008) and more recently the use of simulation software (Murray et al, 2008;Marmulla and Niederdellmann, 1999), have enabled surgeons to plan osteotomies and distraction osteogenesis in three dimensions and to adapt osteosynthesis plates prior to surgery. Using different scanning techniques allowed to predict soft tissue changes (Pektas et al, 2007;Donatsky et al, 2009).…”

Clinical Applications of Rapid Prototyping Models in Cranio-Maxillofacial Surgery

“…The costs of revision procedures and for the replacement of ill-fitting custom implants (which can cost up to $3,000) are significant compared with the cost of applying a centralised rapid medical prototyping service. Many advantages of SL models have been identified: 1) the quality of preoperative planning is greatly improved by allowing a better understanding of the anatomy, and the extent of the disease; 2) the best approach to an osteotomy, and, to the associated surgical site can be assessed, and a more realistic simulation of the surgical steps can be conducted; 3) SL medical models provide an excellent reference when discussing surgical procedures with patients, thus enhancing the validity of informed consent, as the patients gain a greater understanding of the technical difficulties and limitations of the proposed surgery; 4) medical training and surgical education can be undertaken, away from already overcrowded surgical suites, and communication between different specialties allows for a more comprehensive multidisciplinary approach (Cheung et al, 2002); 5) the predicting of results improves with more accurate custom implant manufacturing, preplanned screw placement, and osteotomy design, which also reduces operative time (Arvier et al, 1994;Korves et al, 1995;Murray et al, 2008). SL models can also be sterilised and used directly in the operating theatre.…”