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

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



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.

Address correspondence and reprint requests to Dr Praveen Ganesh, MDS, FCCS, FCMFS, Assistant Professor and Craniofacial Surgeon, Department of Plastic, Reconstructive and Craniofacial Surgery, Saveetha Medical College and Hospital, Chennai 602015, India; E-mail: prgfacsurg@gmail.com

Received 11 May, 2020

Accepted 23 August, 2020

The authors report no conflicts of interest.

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© 2020 by Mutaz B. Habal, MD.