Doing More with Less3D-Printed Craniosynostosis Model: New Simulation Surgical Tool
Introduction
Craniosynostosis is often a complex disease, generally involving orbital and facial bones together with the cranial deformity. Treatment is sometimes challenging, and surgical correction requires a multidisciplinary approach with association of neurosurgeon and plastic surgeon skills. Surgical expertise and meticulous techniques are required to achieve the best cosmetic and functional results and to improve patient safety.1
Training surgeons to perform craniofacial procedures is particularly challenging, as the majority of procedures carry a high risk and a minor mistake can be fatal. Considering that medical-legal issues preclude mistakes during the learning curve of young surgeons,2, 3 simulation-based training models can be useful to transpose these educational obstacles; however, as far as we know, a refined simulation model is still lacking.4, 5, 6
An ideal training model for craniosynostosis should provide all the complex anatomy of the cranial base, the most common pathologic variations, and tactile feedback of performing osteotomies. In this context, 3D-printed models may provide an accurate reproduction of bone anatomy and specific pathologic nuances. 3D-printed models can be used for surgical training and surgical planning, which may improve the safety of the procedure and understanding of each patient's craniosynostosis nuances.
The objective of this report is to present novel 3D-printed polyamide craniosynostosis models that can improve the understanding and treatment complex pathologies while promoting a cost-effective and trending form of education.
Section snippets
Data Acquisition
To obtain data for model manufacturing, we collected computed tomography (CT) images of our craniofacial clinic patients. We obtained CT scan images with a slice thickness of 1 mm, of patients 6–9 months of age, diagnosed with craniosynostosis (single suture or complex craniosynostosis). Most CT and magnetic resonance imaging units have the ability to export data in common medical file format—digital imaging and communication in medicine (DICOM).
After saving CT or magnetic resonance imaging
Results
We have produced 3 craniosynostosis models based on the image examinations of 3 patients: 1) simple sagittal stenosis, 2) bilateral coronal stenosis, and 3) complex multisutural stenosis with coronal and lambdoid stenosis. The models allowed adequate surgical planning (see Figure 2) and performing the 3 most common procedures in craniosynostosis treatment (see Figure 3): fronto-orbital advancement, Pi procedure, and posterior distraction.
All aspects of craniofacial anatomy could be shown on the
Discussion
Simulation provides a safe learning environment and has the ability to expose the trainee to problems of varying complexity levels.14 An excellent example of success using simulation is in the aviation industry, which was a pioneer of using flight simulation models. Simulation is already an important tool in medical and resident education in other areas of medicine15, 16, 17 and is gaining acceptance in neurosurgery as more validated tools and assessment methods are developed.18, 19, 20
Conclusions
Simulation is becoming an essential part of medical education for surgical training and for improving surgical safety with adequate planning. We propose a 3D-printed model used to create patient-specific geometries to replace bone structures. The biomodel geometries were designed on the basis of head CT scans of real craniosynostosis patients that allow the experience of dealing with such challenging pathologies. The ability to reproduce the unique complex bone abnormalities present in
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Conflict of interest statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. None of the authors has any conflict of interest to disclose.