An average three-dimensional virtual human skull for a template-assisted maxillofacial surgery.

Area of Science:

• Medical Imaging
• Surgical Planning
• Biomedical Engineering

Background:

• Achieving facial harmony in maxillofacial surgery remains challenging, often relying heavily on surgeon experience.
• Advances in 3D virtual planning have yet to fully address this complexity.

Purpose of the Study:

• To present a method for creating an average 3D virtual human skull.
• To utilize this average skull as a reference template for bone repositioning and reconstruction in maxillofacial surgery.

Main Methods:

• Collected and processed 3D cone-beam computed tomography scans from 20 patients (10 male, 10 female) post-orthognathic surgery.
• Registered 3D skull models to compute average male and female 3D virtual skull models.
• Calculated deviation maps and presented a genioplasty use case with the template.

Main Results:

• Mean deviations from the average model were 1.3 ± 0.6 mm (males) and 1.6 ± 0.5 mm (females).
• Greatest deviations occurred in the mandible; minimal deviations were observed in zygomatic and orbital areas.
• The average female 3D skull model successfully guided surgical planning in a clinical case.

Conclusions:

• The developed method provides a novel approach for creating average 3D virtual skulls.
• This technique offers a promising perspective for innovative template-assisted maxillofacial surgery.
• The average 3D virtual skull serves as a valuable reference for enhancing surgical precision and outcomes.