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Custom implant design for large cranial defects

  • Filipe M. M. MarreirosEmail author
  • Y. Heuzé
  • M. Verius
  • C. Unterhofer
  • W. Freysinger
  • W. Recheis
Original Article

Abstract

Purpose

The aim of this work was to introduce a computer-aided design (CAD) tool that enables the design of large skull defect (>100 \(\mathrm{cm}^2\)) implants. Functional and aesthetically correct custom implants are extremely important for patients with large cranial defects. For these cases, preoperative fabrication of implants is recommended to avoid problems of donor site morbidity, sufficiency of donor material and quality. Finally, crafting the correct shape is a non-trivial task increasingly complicated by defect size.

Methods

We present a CAD tool to design such implants for the neurocranium. A combination of geometric morphometrics and radial basis functions, namely thin-plate splines, allows semiautomatic implant generation. The method uses symmetry and the best fitting shape to estimate missing data directly within the radiologic volume data. In addition, this approach delivers correct implant fitting via a boundary fitting approach.

Results

This method generates a smooth implant surface, free of sharp edges that follows the main contours of the boundary, enabling accurate implant placement in the defect site intraoperatively. The present approach is evaluated and compared to existing methods. A mean error of 89.29 % (72.64–100 %) missing landmarks with an error less or equal to 1 mm was obtained.

Conclusion

In conclusion, the results show that our CAD tool can generate patient-specific implants with high accuracy.

Keywords

Cranial reconstruction Reconstructive surgery Geometric morphometrics Radial basis functions and thin-plate spline 

Notes

Acknowledgments

The authors would like to thank Brenda Frazier for editorial suggestions. We would like also to thank Philipp Gunz and Demetrios Halazonetis for their explanations of GM methods used in this work. This work was supported by the EU FP6 Marie Curie Actions EVAN, contract number: MRTN-CT-2005-019564.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required, since all the patient data were anonymized.

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Copyright information

© CARS 2016

Authors and Affiliations

  • Filipe M. M. Marreiros
    • 1
    • 2
    • 3
    Email author
  • Y. Heuzé
    • 4
  • M. Verius
    • 5
  • C. Unterhofer
    • 6
  • W. Freysinger
    • 7
  • W. Recheis
    • 5
  1. 1.Center for Medical Image Science and Visualization (CMIV)Linköping UniversityLinköpingSweden
  2. 2.Department of Medical and Health Sciences (IMH)Linköping UniversityLinköpingSweden
  3. 3.Department of Science and Technology (ITN) - Media and Information Technology (MIT)Linköping UniversityLinköpingSweden
  4. 4.University of Bordeaux, UMR 5199 PACEA, Bordeaux Archaeological Sciences Cluster of ExcellenceUniversité de BordeauxPessac CedexFrance
  5. 5.Department of RadiologyInnsbruck Medical UniversityInnsbruckAustria
  6. 6.Clinical Department of NeurosurgeryInnsbruck Medical UniversityInnsbruckAustria
  7. 7.Department of Otorhinolaryngology (ENT), Hearing, Speech and Voice DisordersInnsbruck Medical UniversityInnsbruckAustria

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