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Virtual Surgical Planning for Correction of Delayed Presentation Scaphocephaly Using a Modified Melbourne Technique
Alexandra Macmillan1, Joseph Lopez1, Gerhard S Mundinger2
1Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD.
The Journal of Craniofacial Surgery
|February 27, 2018
Summary
Virtual surgical planning aids in treating late scaphocephaly (abnormal head shape). This method, using a modified Melbourne technique, shows promising results for total vault remodeling in older children.
Area of Science:
- Neurosurgery
- Pediatric Plastic Surgery
- Craniofacial Surgery
Background:
- Late treatment of scaphocephaly poses surgical challenges.
- Virtual surgical planning (VSP) for total vault reconstruction has not been studied in this complex setting.
Purpose of the Study:
- To evaluate the efficacy of VSP-assisted cranial vault reconstruction for late-presenting scaphocephaly.
Main Methods:
- Retrospective review of patients with scaphocephaly aged 12 months or older (2000-2014).
- Inclusion of patients who underwent VSP-assisted cranial vault reconstruction.
- Comparison of pre-operative, simulated VSP, and actual post-operative anthropometric measurements (fronto-occipital distance, biparietal distance, cephalic index).
Main Results:
- Five patients met inclusion criteria; mean age 50.6 months.
- Postoperative outcomes were favorable, with one patient requiring revision surgery (Whitaker score 1).
- VSP accurately predicted postoperative dimensions, with minimal differences between simulated and actual measurements.
Conclusions:
- Virtual surgical planning using a modified Melbourne technique is effective for total vault remodeling in late-presenting scaphocephaly.
- VSP facilitates good aesthetic and functional outcomes in complex cases.
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