He, KH;
Bruse, JL;
Rodriguez-Florez, N;
Dunaway, D;
Jeelani, O;
Schievano, S;
Borghi, A;
(2024)
Understanding the influence of surgical parameters on craniofacial surgery outcomes: a computational study.
Royal Society Open Science
, 11
(4)
, Article 231158. 10.1098/rsos.231158.
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Abstract
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.
| Type: | Article |
|---|---|
| Title: | Understanding the influence of surgical parameters on craniofacial surgery outcomes: a computational study |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1098/rsos.231158 |
| Publisher version: | http://dx.doi.org/10.1098/rsos.231158 |
| Language: | English |
| Additional information: | © 2024 The Authors. Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited. |
| Keywords: | craniofacial surgery, craniosynostosis, design of experiments, finite-element modelling, pre-operative planning |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Childrens Cardiovascular Disease |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10190970 |
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