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On the Assets of CAD Planning for Craniosynostosis Surgery

Mommaerts, Maurice Y. LDS, MD, DMD, FEBOMS*; Jans, Geert MSc; Sloten, Jos Vander PhD; Staels, Patrick F. J. MD; Van der Perre, Georges PhD; Gobin, Robert MSc

Journal of Craniofacial Surgery: November 2001 - Volume 12 - Issue 6 - p 547-554
Clinical Notes

SkullWiz is a computer-aided design program that transforms computer tomographic data of the neurocranium into a mathematical model that can be interactively manipulated to plan craniosynostosis surgery. Proper planning of this type of surgery involves reference to the underlying viscerocranium and to normal neurocranial dimensions, simulation of all basic surgical actions (closed and open osteotomy, translation, rotation, bending, removal, burring), and reference to the mechanical properties of calvarial bone at a given age. With SkullWiz, infinite trials are possible to develop a surgical plan that combines minimal action with maximum morphologic result. In contrast, physical models, e.g., foam milled or stereolitographic, provide just a single (or double, after gluing) opportunity to visualize three-dimensional morphology and simulate a treatment plan, without reference support. Validation of SkullWiz is difficult due to parameter variability. Its assets are therefore graphically exemplified in two common types of nonsyndromatic single-suture craniosynostosis—trigonocephaly and anterior plagiocephaly. SkullWiz is one of the most accurate planning tools currently available for craniosynostosis surgery. Accurate transfer of the planning by aluminium templates results in efficient and precise surgery by avoiding per-operative “chipping and fitting.”

Bruges & Leuven, Belgium

From the *Division of Maxillo-Facial Surgery, Department of Surgery and Cleft Palate & Craniofacial Anomalies Team, General Hospital St. Jan, Bruges, Belgium; †Division of Biomechanics and Engineering Design, Katholieke Universiteit Leuven, Belgium; and the ‡Department of Neurosurgery and Cleft Palate & Craniofacial Anomalies Team, General Hospital St. Jan, Bruges, Belgium.

This paper was read in part at the 2000 Meeting of the International Cleft Lip Palate Foundation, Zurich, Switzerland, July 2000.

SkullWiz v1 is noncommercial software, property of the KULeuven, but free to use for interested craniofacial surgeons and neurosurgeons.

Address correspondence to Dr Maurice Mommaerts, Division of Maxillo-Facial Surgery, General Hospital St. Jan, 8000 Brugge, Belgium; E-mail:

© 2001 Mutaz B. Habal, MD