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Three-dimensional photography for intraoperative morphometric analysis in metopic craniosynostosis surgery

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Surgical correction of metopic craniosynostosis typically involves open cranial vault remodeling. Accurate translation of the virtual surgical plan into the operating room is challenging due to the lack of tools for intraoperative analysis of the surgical outcome. This study aimed to evaluate the feasibility of using a hand-held 3D photography device for intraoperative evaluation and guidance during cranial vault surgical reconstruction.

Methods

A hand-held structured light scanner was used for intraoperative 3D photography during five craniosynostosis surgeries, obtaining 3D models of skin and bone surfaces before and after the remodeling. The accuracy of this device for 3D modeling and morphology quantification was evaluated using preoperative computed tomography imaging as gold-standard. In addition, the time required for intraoperative 3D photograph acquisition was measured.

Results

The average error of intraoperative 3D photography was 0.30 mm. Moreover, the interfrontal angle and the transverse forehead width were accurately measured in the 3D photographs with an average error of 0.72 degrees and 0.62 mm. Surgeon’s feedback indicates that this technology can be integrated into the surgical workflow without substantially increasing surgical time.

Conclusion

Hand-held 3D photography is an accurate technique for objective quantification of intraoperative cranial vault morphology and guidance during metopic craniosynostosis surgical reconstruction. This noninvasive technique does not substantially increase surgical time and does not require exposure to ionizing radiation, presenting a valuable alternative to computed tomography imaging. The proposed methodology can be integrated into the surgical workflow to assist during cranial vault remodeling and ensure optimal surgical outcomes.

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Availability of data and material

The datasets generated and/or analyzed during the current study are publicly available at https://doi.org/10.6084/m9.figshare.13078925.v1.

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Acknowledgements

The authors would like to thank the surgeons of the Department of Oral and Maxillofacial Surgery and Department of Neurosurgery at Hospital General Universitario Gregorio Marañón for their feedback and help in this study.

Funding

This work was supported by projects PI18/01625 (Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III and European Regional Development Fund “Una manera de hacer Europa”), R42 HD081712 (Eunice Kennedy Shriver National Institute of Child Health and Human Development), and K99DE027993 (National Institute of Dental and Craniofacial Research).

Author information

Authors and Affiliations

  1. Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avenida de la Universidad 30, 28911, Leganés, Madrid, Spain

    David García-Mato, Mónica García-Sevilla & Javier Pascau

  2. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain

    David García-Mato, Mónica García-Sevilla, Santiago Ochandiano, Juan V. Darriba-Allés, Roberto García-Leal, José I. Salmerón & Javier Pascau

  3. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital, Washington, DC, USA

    Antonio R. Porras & Marius George Linguraru

  4. Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Santiago Ochandiano & José I. Salmerón

  5. Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Juan V. Darriba-Allés & Roberto García-Leal

  6. School of Medicine and Health Sciences, George Washington University, Washington, DC, USA

    Marius George Linguraru

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  1. David García-Mato
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  6. Roberto García-Leal
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Contributions

D.G.M. wrote the main manuscript text and prepared all figures and tables. D.G.M., M.G.S. and A.R.P performed data acquisition and processing. M.G.L. contributed to the design of the workflow for morphological analysis. M.G.S., A.R.P., S.O., M.G.L., and J.P. substantively revised the manuscript text. S.O., J.V.D.A., R.G.L., and J.I.S. helped in the conception and design of the proposed workflow for optimal translation into the clinical practice. All authors reviewed the manuscript.

Corresponding author

Correspondence to Javier Pascau.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethics approval

The study was approved by the Research Ethics Committee at Hospital General Universitario Gregorio Marañón and performed in accordance with the principles of the 1964 Declaration of Helsinki as revised in 2013.

Informed consent

Informed consents were obtained from the parents or legal guardians.

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García-Mato, D., García-Sevilla, M., Porras, A.R. et al. Three-dimensional photography for intraoperative morphometric analysis in metopic craniosynostosis surgery. Int J CARS 16, 277–287 (2021). https://doi.org/10.1007/s11548-020-02301-0

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  • DOI: https://doi.org/10.1007/s11548-020-02301-0

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