Skull reconstruction planning transfer to the operation room by thin metallic templates: clinical results.

Introduction: Craniofacial malformations implicate a risk of medical complications and a negative psychological impact on the patient. In order to correct functional and aesthetic aspects of these malformations, skull reconstruction is required. Because of the complexity of the surgery, pre-operative planning is unavoidable. Current and previously developed planning environments often lack the opportunity to transfer the simulated surgery to the operation room on a cheap but accurate, and easy to handle basis. Materials and methods: This study applies an automated filter procedure, implemented in Matlab (R), to generate a set of adapted contours from which a surface mesh can be directly deduced. Skull reconstruction planning is performed on the generated outer bone surface model. For each resected/osteotomized bone part, the presented semi-automatic Matlab (R) procedure generates surface based bone cutting guides, also denoted bone segment templates. Autoclaved aluminium templates transfer the surgical plan to the operation room. Results: The clinical feasibility is demonstrated by the successful pre-operative planning and surgical correction of three skull reconstruction cases in which the proposed procedure leads to considerable reduction in surgery time and good results. Conclusion: A cost-efficient and planning-environment-independent solution is generated for an accurate and fast transfer of a complex cranial surgery plan to the operation room.