Improving Cranial Vault Remodeling for Unilateral Coronal Craniosynostosis—Introducing Automated Surgical Planning

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Craniomaxillofacial Trauma & Reconstruction Pub Date : 2023-06-16 DOI:10.7939/R3-T2A1-5G68
Emilie M. Robertson
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Abstract

Cranial vault remodeling (CVR) for unicoronal synostosis is challenging due to the asymmetric nature of the deformity. Computer-automated surgical planning has demonstrated success in reducing the subjectivity of decision making in CVR in symmetric subtypes. This proof of concept study presents a novel method using Boolean functions and image registration to automatically suggest surgical steps in asymmetric craniosynostosis. The objective of this study is to introduce automated surgical planning into a CVR virtual workflow for an asymmetric craniosynostosis subtype. Virtual workflows were developed using Geomagic Freeform Plus software. Hausdorff distances and color maps were used to compare reconstruction models to the preoperative model and a control skull. Reconstruction models were rated as high or low performing based on similarity to the normal skull and the amount of advancement of the frontal bone (FB) and supra-orbital bar (SOB). Fifteen partially and fully automated workflow iterations were carried out. FB and SOB advancement ranged from 3.08 to 10.48 mm, and −1.75 to 7.78 mm, respectively. Regarding distance from a normal skull, models ranged from .85 to 5.49 mm at the FB and 5.40 to 10.84 mm at the SOB. An advancement of 8.43 mm at the FB and 7.73 mm at the SOB was achieved in the highest performing model, and it differed to a comparative normal skull by .02 mm at the FB and .48 mm at the SOB. This is the first known attempt at developing an automated virtual surgical workflow for CVR in asymmetric craniosynostosis. Key regions of interest were outlined using Boolean operations, and surgical steps were suggested using image registration. These techniques improved post-operative skull morphology
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改善单侧冠状颅缝闭锁的颅拱顶重塑——引入自动化手术计划
由于畸形的不对称性质,颅拱顶重塑(CVR)是具有挑战性的。计算机自动手术计划已证明成功地减少了对称亚型CVR决策的主观性。这个概念验证研究提出了一种使用布尔函数和图像配准的新方法来自动建议不对称颅缝闭锁的手术步骤。本研究的目的是将自动手术计划引入到不对称颅缝闭合亚型的CVR虚拟工作流程中。使用Geomagic Freeform Plus软件开发虚拟工作流。利用Hausdorff距离和彩色地图将重建模型与术前模型和对照颅骨进行比较。根据重建模型与正常颅骨的相似性以及额骨(FB)和眶上骨棒(SOB)的前移量,对重建模型的表现进行了高或低评级。执行了15个部分和完全自动化的工作流迭代。FB和SOB的推进幅度分别为3.08 ~ 10.48 mm和- 1.75 ~ 7.78 mm。关于与正常颅骨的距离,模型在前颅骨为0.85至5.49 mm,后颅骨为5.40至10.84 mm。在表现最好的模型中,FB和SOB的前进分别为8.43 mm和7.73 mm,与正常颅骨相比,FB和SOB的前进分别为0.02 mm和0.48 mm。这是为不对称颅缝闭合的CVR开发自动虚拟手术流程的首次尝试。使用布尔运算勾勒出感兴趣的关键区域,并使用图像配准建议手术步骤。这些技术改善了术后颅骨形态学
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Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
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