Cranioplasty And Orbital Roof Reconstruction – Case Study 1

CMF Case Study 1 - Cranioplasty And Orbital Roof Reconstruction 1

Overview

Following a fall, the patient had a huge defect involving the orbital roof and the frontal area. A surgery is needed in order to restore the function of protection of the skull and the symmetry of the patient.

Segmentation

Based on the high-resolution CT scan of the patient (0.5mm slice thickness), we reconstructed the anatomy in 3D. This first step is called segmentation and is performed by selecting the Hounsfield units (level of grey) corresponding to bone on the CT scan.

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Virtual Simulation

During this step, we simulated the surgery virtually using a software. A mirror of the anatomy is first created (in red) – this helps determine the ideal anatomy needed by mirroring the normal side. The osteotomy of the superior orbital rim (in orange) is simulated virtually and the mirror is used to reposition the superior orbital rim. The symmetry is then restored.

Design Of Patient Specific Devices

Two patient-specific implants were designed, based on the mirror. The patient-specific implants had a complementary shape to facilitate positioning. One implant reconstructs the orbital roof and the other one reconstructs the defect in the frontal area. Both of them would be 3D printed in titanium alloy (Ti6Al4V).

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Outcome

Thanks to the 3D printed titanium plate, the brain is now protected again as the titanium plate made to scale now covers the defect. With the help of virtual simulation and 3D printing, it was possible to reconstruct the anatomy in a symmetrical way, improving the patient’s aesthetic.