Understanding the influence of surgical parameters on craniofacial surgery outcomes: a computational study.

Autor:	He KH; Ningbo University, Ningbo, People's Republic of China.; Great Ormond Street Institute of Child Health, University College London, London, UK., Bruse JL; Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), San Sebastian, Spain., Rodriguez-Florez N; Universidad de Navarra, TECNUN Escuela de Ingenieros, San Sebastian, Spain.; Ikerbasque, Basque Foundation for Science, Bilbao, Spain., Dunaway D; Great Ormond Street Institute of Child Health, University College London, London, UK.; Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK., Jeelani O; Great Ormond Street Institute of Child Health, University College London, London, UK.; Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK., Schievano S; Great Ormond Street Institute of Child Health, University College London, London, UK.; Institute of Cardiovascular Science, University College London, London, UK.; Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK., Borghi A; Great Ormond Street Institute of Child Health, University College London, London, UK.; Craniofacial Unit, Great Ormond Street Hospital for Children, London, UK.; Department of Engineering, Durham University, Durham, UK.
Jazyk:	angličtina
Zdroj:	Royal Society open science [R Soc Open Sci] 2024 Apr 03; Vol. 11 (4), pp. 231158. Date of Electronic Publication: 2024 Apr 03 (Print Publication: 2024).
DOI:	10.1098/rsos.231158
Abstrakt:	Sagittal craniosynostosis (SC) is a congenital condition whereby the newborn skull develops abnormally owing to the premature ossification of the sagittal suture. Spring-assisted cranioplasty (SAC) is a minimally invasive surgical technique to treat SC, where metallic distractors are used to reshape the newborn's head. Although safe and effective, SAC outcomes remain uncertain owing to the limited understanding of skull-distractor interaction and the limited information provided by the analysis of single surgical cases. In this work, an SC population-averaged skull model was created and used to simulate spring insertion by means of the finite-element analysis using a previously developed modelling framework. Surgical parameters were varied to assess the effect of osteotomy and spring positioning, as well as distractor combinations, on the final skull dimensions. Simulation trends were compared with retrospective measurements from clinical imaging (X-ray and three-dimensional photogrammetry scans). It was found that the on-table post-implantation head shape change is more sensitive to spring stiffness than to the other surgical parameters. However, the overall end-of-treatment head shape is more sensitive to spring positioning and osteotomy size parameters. The results of this work suggest that SAC surgical planning should be performed in view of long-term results, rather than immediate on-table reshaping outcomes. Competing Interests: We declare we have no competing interests (© 2024 The Authors.)
Databáze:	MEDLINE
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