Skull reconstruction using parietal flaps

CMF Case Study 4 1

Following a fall, the patient had a huge defect involving the orbital roof.

CMF Case Study 4 2

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.

CMF Case Study 4 3

 

 

A mirror is first created (in red).

The osteotomy of the superior orbital rim (in orange) is simulated and the mirror is used to repositioned the superior orbital rim.

 

 

 

 

The symmetry is restored

 

 

 

 

Two patient-specific guides were designed, based on the virtual simulation of the surgery.

The patient-specific guides have a complementary shape to facilitate positioning. One jig is guiding the trimming of the defect edges while the other one is indicating the parietal flaps to harvest.

In the frontal guide is also included some drilling channels, corresponding to the position of the future patient-specific osteosynthesis plates.

 

CMF Case Study 4 4

CMF Case Study 4 5

By aligning the patient-specific plates to the previously drilled holes, the flaps are positioned as virtually planned.

No adaptation is needed.

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