Computer-assisted planning and modeling for the surgical treatment of patients with fibrous dysplasia of cranial vault and base

Rakityansky MM, Satanin LA, Ivanov AL, et al. . Computer-assisted planning and modeling for the surgical treatment of patients with fibrous dysplasia of cranial vault and base. Burdenko's Journal of Neurosurgery. 2025;89(2):29‑38. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20258902129

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

Использование инфографики авторами научных работ

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BACKGROUND

The probability of cranial lesions in fibrous dysplasia reaches 50%. A pre-operative computer-assisted planning provides opportunities for precise radical bone resection and customized xenograft manufacturing.

OBJECTIVE

To evaluate postoperative outcomes in patients with fibrous dysplasia of the cranial vault and base, achived by means of preoperative computer-assisted planning and modeling.

MATERIAL AND METHODS

There were 32 patients with fibrous dysplasia of skull cranioorbital and vault localisation in Moscow National Medical Research Center for Neurosurgery named after Academician N.N. Burdenko from 2008 to 2024. All patients underwent a virtual lesion resection, a surgical template and a customized implant or its mold modelling. Implants were mostly manufactured from polymethylmethacrylate either before or during the surgery. The peculiarities of surgeries were application of template to dysplastic bone, resection within appropriate contour and subsequent cranioplasty with customized cranial implant. After surgery, we performed CT and analyzed deviations between postoperative and virtual skull. Reconstruction quality was assessed evaluating cranial asymmetry by means of craniometric analysis.

RESULTS

Craniometric measurements of asymmetry proved the effectiveness of surgical skull correction. The part comparison analysis of skull models after a computer-assisted planning and operations revealed convenience and predictability of the chosen approach.

CONCLUSION

The developed complex of preoperative computer-assisted planning and modeling significantly improved resection and cranioplasty quality.

Keywords:

fibrous dysplasia

preoperative computer-assisted planning

surgical template

cranioplasty

customized cranial implant

Authors:

Rakityansky M.M.

Pirogov Russian National Research Medical University

ORCID: 0009-0003-4555-7339

Satanin L.A.

Burdenko Neurosurgical Center

ORCID: 0000-0003-2051-1855

Ivanov A.L.

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0002-0732-0942

Rudnev S.G.

Marchuk Institute of Numerical Mathematics, Russian Academy of Sciences

ORCID: 0000-0001-5437-8429

Sakharov A.V.

Burdenko Neurosurgical Center

ORCID: 0000-0001-5119-6814

Duvidzon V.G.

«AB Universal» Engineering Company

ORCID: 0009-0006-1079-4395

Semushin M.A.

Burdenko Neurosurgical Center

ORCID: 0009-0007-7300-5047

Burkhan E.S.

«Bonabyte» Engineering Company

ORCID: 0009-0005-8565-0882

Roginsky V.V.

Central Research Institute of Dentistry and Maxillofacial Surgery

SPIN RSCI: 2873-4899
ORCID: 0000-0003-0549-855X

Received:

19.09.2024

Accepted:

30.01.2025

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