Traditional Versus Virtual Surgery Planning of the Fronto-Orbital Unit in Anterior Cranial Vault Remodeling Surgery

Abstract

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.

Mesothelial cyst in a young female: Case report and literature review

“…The key characteristics of the study are presented in Table 2. All the included studies [23][24][25][26][27][28][29][30][31][32][33][34] were from past 10 years to align with the latest technology present in the market. The oldest study [28] was from 2012 and earliest [31] published in 2021.…”

“…All the included studies [23][24][25][26][27][28][29][30][31][32][33][34] were from past 10 years to align with the latest technology present in the market. The oldest study [28] was from 2012 and earliest [31] published in 2021. Sample size for patient population was diversified across the studies; three studies [27,30,31] had very small sample size (n≤10), eight studies [23][24][25]28,29,[32][33][34] had moderate sample size (between 10 to 75), while one study [26] (n=203) had the largest patient population.…”

“…Sample size for patient population was diversified across the studies; three studies [27,30,31] had very small sample size (n≤10), eight studies [23][24][25]28,29,[32][33][34] had moderate sample size (between 10 to 75), while one study [26] (n=203) had the largest patient population. Two studies [25,29] mentioned median age while the rest of the studies [23,24,[26][27][28][30][31][32][33][34]provided mean age of the patients at the time of the surgery, which was considered to be less than two years for the review due to its efficacy for CVR. Several studies had an overlap in the technologies used which consisted of CAD/CAM, VSP, 3D printing, 3D simulation, resorbable plating, 3D photogrammetry, and Image Guided Surgery (IGS).…”

“…Several studies had an overlap in the technologies used which consisted of CAD/CAM, VSP, 3D printing, 3D simulation, resorbable plating, 3D photogrammetry, and Image Guided Surgery (IGS). Technologies were deployed at three categorically different stages; eight studies [23,27,28,[30][31][32][33][34] used at pre-surgical stage, eight [24][25][26][27][28][29][30]32] during intraoperative and two [28,34] at post-surgery stage either as a stand alone or in combination with each other. None of the technologies were in prototype stage and are commercially available at the time of the systematic review.…”

“…The average error between target and transverse forehead width was 1.89 mm. Ganesh, et al [31] exhibited the use of CAD/CAM, and VSP in treatment of CS using CVR. A total of 10 patients were divided into two groups; 5 Virtual surgical planning group (VFOU) having a mean age of 7.4 months and 5 Non-template Fronto-Orbital Unit (NFOU) group which was the control group having a mean age of 7 months.…”