Use of computer-assisted design and manufacturing to localize dural venous sinuses during reconstructive surgery for craniosynostosis
Autor: | Amir H. Dorafshar, Alexandra Macmillan, Joseph Lopez, Edward S. Ahn, Adela Wu, Rajiv R. Iyer, Regina S. Cho, Leila Musavi, George I. Jallo |
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Rok vydání: | 2017 |
Předmět: |
Male
Reconstructive surgery medicine.medical_specialty Adolescent Cranial Sinuses Neurosurgical Procedures Patient Care Planning Craniosynostosis Craniosynostoses 03 medical and health sciences Postoperative Complications 0302 clinical medicine otorhinolaryngologic diseases medicine Humans Child Unicoronal synostosis Sinus (anatomy) Retrospective Studies business.industry Infant General Medicine Length of Stay Plastic Surgery Procedures Synostosis medicine.disease Sagittal plane Surgery Sagittal suture Treatment Outcome medicine.anatomical_structure Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Dural venous sinuses Computer-Aided Design Female Dura Mater Neurology (clinical) Tomography X-Ray Computed business 030217 neurology & neurosurgery |
Zdroj: | Child's Nervous System. 34:137-142 |
ISSN: | 1433-0350 0256-7040 |
Popis: | Cranial vault remodeling surgery for craniosynostosis carries the potential risk of dural venous sinus injury given the extensive bony exposure. Identification of the dural venous sinuses can be challenging in patients with craniosynostosis given the lack of accurate surface-localizing landmarks. Computer-aided design and manufacturing (CAD/CAM) has allowed surgeons to pre-operatively plan these complex procedures in an effort to increase reconstructive efficiency. An added benefit of this technology is the ability to intraoperatively map the dural venous sinuses based on pre-operative imaging. We utilized CAD/CAM technology to intraoperatively map the dural venous sinuses for patients undergoing reconstructive surgery for craniosynostosis in an effort to prevent sinus injury, increase operative efficiency, and enhance patient safety. Here, we describe our experience utilizing this intraoperative technology in pediatric patients with craniosynostosis. We retrospectively reviewed the charts of children undergoing reconstructive surgery for craniosynostosis using CAD/CAM surgical planning guides at our institution between 2012 and 2016. Data collected included the following: age, gender, type of craniosynostosis, estimated blood loss, sagittal sinus deviation from the sagittal suture, peri-operative outcomes, and hospital length of stay. Thirty-two patients underwent reconstructive cranial surgery for craniosynostosis, with a median age of 11 months (range, 7–160). Types of synostosis included metopic (6), unicoronal (6), sagittal (15), lambdoid (1), and multiple suture (4). Sagittal sinus deviation from the sagittal suture was maximal in unicoronal synostosis patients (10.2 ± 0.9 mm). All patients tolerated surgery well, and there were no occurrences of sagittal sinus, transverse sinus, or torcular injury. The use of CAD/CAM technology allows for accurate intraoperative dural venous sinus localization during reconstructive surgery for craniosynostosis and enhances operative efficiency and surgeon confidence while minimizing the risk of patient morbidity. |
Databáze: | OpenAIRE |
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