Best face forward: Virtual modeling and custom device fabrication to optimize craniofacial vascularized composite allotransplantation

Plast Reconstr Surg. 2013 Jan;131(1):64-70. doi: 10.1097/PRS.0b013e3182729ef0.

Abstract

Craniofacial vascularized composite allotransplantation is especially challenging when bony components are required. Matching the complex three-dimensional anatomy of the donor and recipient craniofacial skeletons to optimize bony contact and dental occlusion is a time-consuming step in the operating room. Currently, few tools exist to facilitate this process. The authors describe the development of a virtual planning protocol and patient-specific device design to efficiently match the donor and recipient skeletal elements in craniofacial vascularized composite allotransplantation. The protocol was validated in a cadaveric transplant. This innovative planning method allows a "snap-fit" reconstruction using custom surgical guides while maintaining facial height and width and functional occlusion. Postoperative overlay technology in the virtual environment provides an objective outcome analysis.

Publication types

  • Validation Study
  • Video-Audio Media

MeSH terms

  • Clinical Protocols
  • Computer Simulation*
  • Equipment Design
  • Facial Transplantation / instrumentation
  • Facial Transplantation / methods*
  • Humans
  • Imaging, Three-Dimensional
  • Models, Anatomic*
  • Osteotomy / methods
  • Preoperative Care / instrumentation
  • Preoperative Care / methods*
  • Skull / diagnostic imaging
  • Skull / transplantation*
  • Tomography, X-Ray Computed*
  • Transplantation, Homologous
  • User-Computer Interface