Application of digital technology and positioning technology with three-dimensional printing template in treating craniosynostosis secondary to orbital hypertelorism simultaneously
10.3760/cma.j.issn.1009-4598.2020.02.002
- VernacularTitle:数字化和三维打印导板定位技术在同期矫治颅缝早闭继发眶距增宽症中的应用
- Author:
Qinghua HUANG
1
;
Bin YANG
;
Binghang LI
;
Jian NI
Author Information
1. 中国医学科学院北京协和医学院整形外科医院颌面外科中心、数字化整形中心 100144
- Keywords:
Craniosynostosis;
Orbital hypertelorism;
Digital design;
Printing, three-dimensional;
Template
- From:
Chinese Journal of Plastic Surgery
2020;36(2):107-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical effect of digital technology and positioning technology with three-dimensional printing template which were applied systematically in the treatment of craniosynostosis secondary to orbital hypertelorism.Methods:There were 4 cases of congenital premature closure of unilateral coronal suture secondary to orbital hypertelorism treated in the Plastic Surgery Hospital, Chinese Academy of Medical Sciences from June 2015 to August 2019, including 1 male and 3 females, aged from 3 to 8 years. The operation of fronto-orbital advancement and inverted U-shaped osteotomy were used to correct skull malformation and orbital widening simultaneously. Before the operation, surgical plan was designed by digital technology and three-dimensional cranial model and surgical template were printed. During the operation, template was used to guide osteotomy. After the operation, the outcome was evaluated by digital technology. Anterior cranial vault asymmetry index (ACVAI) and inter-orbital distance were calculated by measuring preoperative and postoperative cranial three-dimensional data. The color gradient map was made by ProPlan CMF 3.0 to determine whether the postoperative cranial flap and orbital position were the same as the preoperative design.Results:The 4 patients were successfully received the operation according to the preoperative digital designed plan. The template was highly matched and it did not damage the surrounding tissues during the operation. The duration of osteotomy was shortened to 1-2 hours. There were no complications such as cerebrospinal fluid leakage, infection, intracranial hematoma and eyeball injury. Postoperative follow-up was conducted from 4 months to 3 years. The cranial and orbital appearances of the 4 patients were significantly improved, with ACVAI decreased to less than 3.5% (-1.5%-3.0%) and the postoperative inter-orbital distance was reduced to the normal range (22-28 mm). The color gradient diagram showed that the postoperative effect was highly consistent with the preoperative surgical design.Conclusions:The application of digital technology and positioning technology with three-dimensional printing template systematically used in the treatment of complicated congenital craniosynostosis secondary to orbital hypertelorism can significantly improve the accuracy of osteotomy, reduce the risk of surgery, shorten the operation time, and obtain a more satisfactory appearance.
