• Title/Summary/Keyword: Skull reconstruction

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Comparision of Imaging Features with Surgical Findings in the Patients with Craniosynostosis (두개골조기유합증 환자에서 영상소견과 수술소견의 비교)

  • Kim, Hyung Soo;Park, Se-Hyuck;Cho, Byung Moon;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1417-1421
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    • 2001
  • Objective : The purposes of this study are to compare imaging features with operative findings and to determine significance of imaging studies for early detection of craniosynostosis(CS). Methods : Plain radiograph of skull and three-dimensional(3D) CT reconstruction were analyzed in 10 consecutive patients with CS to assess the presence and the extent of synostosis. The radiological findings were investigated and compared with operative findings. Results : The locations of lesion were coronal suture in 6, sagittal suture in 3 and multiple sutures in one patient, and the age ranged 1 to 53 months(mean age : 17.4 months). Reconstructive procedures with or without advancement of supraorbital rim were performed in coronal CS patients and ${\pi}$-procedures or synostectomy were done in sagittal CS patients. Radi-ological abnormalities such as sutural indistinctness or sclerosis, bony ridge, bossing and other bony deformities were nearly consistent with surgical findings. Conclusion : The interpretation of imaging study are very important for early detection of craniosynostosis, especially, the plain radiographs of skull. Also 3D CT imaging is helpful in diagnosis and surgical planing of craniosynostosis. There are no significant differences between imaging features and operative findings in CS patients.

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Cranioplasty Using Three-Dimensional-Printed Polycaprolactone Implant and Free Latissimus Dorsi Musculocutaneous Flap in a Patient with Repeated Wound Problem following Titanium Cranioplasty

  • Hee Tae Koo;Jeongseok Oh;Chan Yeong Heo
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.740-744
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    • 2022
  • Titanium mesh is an alloplastic material widely used for the reconstruction of moderate-to-large skull defects. Repeated wound problems or infection following these reconstructions inevitably lead to the replacement of the cranioplasty material. Among the various alloplastic materials, polycaprolactone implants are usually used for the coverage of small defects such as burr holes. Herein, we present a case of a large cranial defect successfully reconstructed with three-dimensional-printed polycaprolactone implant and a free latissimus dorsi musculocutaneous flap. Until 1-year followup, the patient showed a favorable esthetic outcome with no complications or wound relapse.

ACCURACY TESTS OF 3D RAPID PROTOTYPING (RP) MEDICAL MODELS: ITS POTENTIAL AND CLINICAL APPLICATIONS (Rapid Prototyping으로 제작한 3D Medical Model의 오차 측정에 관한 연구 (임상 적용 가능성 및 사례))

  • Choi, Jin-Young;Choi, Jung-Ho;Kim, Nam-Kuk;Lee, Jong-Ki;Kim, Myeng-Ki;Kim, Myung-Jin;Kim, Yeong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.295-303
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    • 1999
  • Presented in this paper are the experimental results that measure rapid prototyping (RP) errors in 3D medical models. We identified various factors that can cause dimensional errors when producing RP models, specifically in maxillofacial areas. For the experiment, we used a human dry skull. A number of linear measurements based on landmarks were first obtained on the skull. This was followed by CT scanning, 3D model reconstruction, and RP model fabrication. The landmarks were measured again on both the reconstructed models and the physical RP models, and these were compared with those on dry skull. We focused on major sources of errors, such as CT scanning, conversion from CT data to STL models, and RP model fabrication. The results show that the overall error from skull to RP is $0.64{\times}0.36mm(0.71{\times}0.66%)$ in absolute value. This indicates that the RP technology can be acceptable in the real clinical applications. A clinical case that has applied RP models successfully for treatment planning and surgical rehearsal is presented. Although the use of RP models is rare in the medical area yet, we believe RP is promising in that it has a great potential in developing new tools which can aid diagnosis, treatment planning, surgical rehearsal, education, and so on.

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Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

  • Jang, Hyo Won;Kim, Nam-Kyoo;Lee, Won-Sang;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.83-86
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    • 2014
  • There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

Clinical Usefulness of Titanium Mesh in Reconstruction of the Craniofacial Bone Defects (두개안면골 결손부 재건에 있어서 티타늄 그물판의 임상적 유용성)

  • Seo, Yeong Min;Jeong, Seung Moon
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.688-694
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    • 2006
  • Purpose: Reconstruction of the craniofacial defects can be carried out with autogenous tissues, allogenic implants, or alloplastic materials. Titanium mesh systems have been used for bony reconstruction in non load-bearing areas. They offer several advantages: immediate availibility without any donor site morbidity, easy handling, stable 3-D reconstruction, and low susceptibility to infection. The aim of this study is to evaluate the usefulness and complications of titanium mesh system in the reconstruction of the craniofacial defects. Methods: From Jan. 2000, to Dec. 2004, we performed reconstruction of craniofacial bone defects in 21 patients who had benign or malignant tumor and fracture events in the cranium, orbit, nasal bone, maxilla, zygoma and the mandible. The size of the defects ranged from $1.0{\times}1.5cm$ to $12{\times}10cm$. Two different mesh systems, micro-titanium augmentation mesh and dynamic mesh was used for bony reconstruction in non load-bearing areas. The patients were evaluated from 1 to 4 yrs clinically and radiographically with a mean follow up period of 1.5 yrs. Results: There were no serious complications, including wound infection, foreign body reaction, exposures or loos of the mesh, central infection and pathologic findings of bone around mesh exception of one patient, who had expired of skull base tumor recurrence. Long-term stability of the reconstructions and the overall functional and aesthetic outcome was excellent. Conclusion: Our experiences demonstrate that the Titanium mesh system is a relatively safe and efficient method in the craniofacial reconstruction and have broadens our choices of therapeutic procedures in the craniomaxillofacial surgery.

Optimizing the reconstruction filter in cone-beam CT to improve periodontal ligament space visualization: An in vitro study

  • Houno, Yuuki;Hishikawa, Toshimitsu;Gotoh, Ken-ichi;Naitoh, Munetaka;Mitani, Akio;Noguchi, Toshihide;Ariji, Eiichiro;Kodera, Yoshie
    • Imaging Science in Dentistry
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    • v.47 no.3
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    • pp.199-207
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    • 2017
  • Purpose: Evaluation of alveolar bone is important in the diagnosis of dental diseases. The periodontal ligament space is difficult to clearly depict in cone-beam computed tomography images because the reconstruction filter conditions during image processing cause image blurring, resulting in decreased spatial resolution. We examined different reconstruction filters to assess their ability to improve spatial resolution and allow for a clearer visualization of the periodontal ligament space. Materials and Methods: Cone-beam computed tomography projections of 2 skull phantoms were reconstructed using 6 reconstruction conditions and then compared using the Thurstone paired comparison method. Physical evaluations, including the modulation transfer function and the Wiener spectrum, as well as an assessment of space visibility, were undertaken using experimental phantoms. Results: Image reconstruction using a modified Shepp-Logan filter resulted in better sensory, physical, and quantitative evaluations. The reconstruction conditions substantially improved the spatial resolution and visualization of the periodontal ligament space. The difference in sensitivity was obtained by altering the reconstruction filter. Conclusion: Modifying the characteristics of a reconstruction filter can generate significant improvement in assessments of the periodontal ligament space. A high-frequency enhancement filter improves the visualization of thin structures and will be useful when accurate assessment of the periodontal ligament space is necessary.

Study on the Reconstruction of Skull Prototype using CT image and Laser Scanner

  • Hur, Sung-Min;Lee, Seok-Hee
    • International Journal of Precision Engineering and Manufacturing
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    • v.1 no.1
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    • pp.146-151
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    • 2000
  • The importance of shape reconstruction is increasing in many areas such as RPD(Rapid Product Development) and reverse engineering. Typical data in these areas are mainly classified as the shape data measured by a laser scanner and the data extracted from the CT image. The goal of this research is to realize three-dimensional shape construction by showing a possible way to analyze input image data and reconstruct the original shape. Two main steps of the reconstructing process are obtaining cross-section data from image processing and linking loops between one slice and the next. Objects reconstructed in this way are compared with other objects using a laser scanner and modelled by commercially available software. The technique is expected to be used in reverse engineering applications and the object modeling with automated process.

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The Significance of 3-Dimensional Imaging in Tracheal Stenosis (기관협착증에서 3차원적 영상 진단의 의의)

  • 정동학;봉정표;이운우;노정래;성기준
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.82-93
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    • 1995
  • Three-dimensional reconstruction of computed tomographic image(3D CT) is a well-established imaging modality which has been investigated in various clinical settings. It is commonly performed in case of congenital or developmental abnormalities, and traumatic fracture of skull and face that requires reconstruction of osseous structure. However reporting the 3D CT in laryngeal or tracheal stenosis is rare and its results are obscure. The authors performed 3D CT in six cases of tracheal stenosis and found diagnostic value of 3D CT. A Comparision of diagnostic information obtained from plain X-ray, 2D CT and 3D CT has performed in total six cases of tracheal stenosis. Surgical treatment of the tracheal stenosis was following in these cases : tracheal end to end anastomosis In 1 case, laryngotracheal end to end anastomosis in 2 cases. 3D CT information was compared with operative finding. In two of six cases, satisfactory information was not obtained from 3D CT in evaluating an exact stenosis of trachea. Future, it will be helped in evaluating of tracheal stenosis by 3D CT.

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Modified Anterior Craniofacial Osteotomy Using Partial Nasal Bone Division and Reconstruction in Frontoethmoidal Sinus Meningioma

  • Park, Eon Ju;Kim, Hong Il;Park, Jin Hyung;Yi, Hyung Suk
    • Archives of Craniofacial Surgery
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    • v.18 no.2
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    • pp.117-121
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    • 2017
  • Typical transcranial approaches are insufficient for adequate visualization and resection of skull base tumors. Different approaches with multiple modifications have been attempted. Here, we describe a new approach for a lesion that is central and hard to treat by conventional craniotomy and successful reconstruction with calvarial bone graft and titanium mesh plate. A 69-year-old female patient presented with recurrent meningioma. The tumor had invaded the frontal lobe, right supraorbital rim, and ethmoidal bone. We performed a modified anterior craniofacial approach that fully exposed the tumor and invaded bone. In consideration of the patient's age and cosmetic result, the tumor and invaded bone was resected and the defect area was reconstructed with titanium mesh and calvarial bone graft. At 6 months postoperative the patient had no complications and was satisfied with the esthetic result. We report this case to demonstrate the successful approach and reconstruction using this technique.