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Software-assisted bone thickness evaluation in patients with syndromic craniosynostosis undergoing Le Fort III
V Zanchi1, Y Volpe2, L Genitori3
1Department of Maxillofacial Surgery, Careggi University Hospital, Florence, Italy; Department of Neurosurgery, Meyer Children's Hospital IRCCS and ERN Cranio, Florence, Italy.
International Journal of Oral and Maxillofacial Surgery
|November 6, 2024
Summary
Software for evaluating cranial bone thickness aids surgical planning for Le Fort III osteotomy in syndromic patients. This tool helps determine eligibility for distraction osteogenesis, improving outcomes and avoiding complications.
Area of Science:
- Craniofacial Surgery
- Medical Imaging
- Biomechanical Engineering
Background:
- Le Fort III osteotomy is a complex procedure for syndromic craniosynostosis.
- Preoperative assessment of cranial bone thickness is crucial for surgical technique selection.
- Distraction osteogenesis offers an alternative to traditional midface advancement.
Purpose of the Study:
- To evaluate the utility of specialized software in assessing cranial bone thickness.
- To determine patient suitability for distraction osteogenesis versus traditional Le Fort III osteotomy.
- To correlate bone thickness measurements with surgical outcomes.
Main Methods:
- Computed tomography (CT) scans were analyzed using reverse engineering software.
- Temporal bone thickness was measured to assess suitability for rigid external distractor devices.
- Patients were categorized based on bone thickness for surgical planning.
Main Results:
- Three out of four patients had sufficient bone thickness (>3.5 mm) for distraction osteogenesis.
- One patient with insufficient bone thickness (<2.5 mm) underwent traditional Le Fort III osteotomy.
- Distraction osteogenesis resulted in adequate midface advancement without complications; the traditional technique led to a shorter advancement and a cerebrospinal fluid fistula.
Conclusions:
- Software-based preoperative evaluation of cranial bone thickness is valuable for Le Fort III osteotomy planning in syndromic patients.
- Accurate bone thickness assessment guides the choice between distraction osteogenesis and traditional techniques.
- This approach can optimize surgical outcomes and potentially reduce complications.
