02/12/2010
AO Technical Commission Approved

Sterile Artificial Skull

The new artificial sterilizable skull is the first autoclavable, one-piece human skull model intended for aiding initial plate contouring in the operating room, and for visualizing facial structures.

There is a need for sterile artificial skulls for any craniomaxillofacial (CMF) surgeon who provides CMF reconstructions. The clinical reality is that surgeons worldwide have individual methods to address this need due to the difficulty and lack of anatomical reference points in cases with large bone defects. However, the skull model needs to be mechanically strong for intraoperative contouring of plates, meshes, and biomaterials.

The patients anatomy is essential for a proper and adequate reconstruction of the defects. Improper contouring of the plates may lead to complications resulting in functional and/or aesthetic problems that require secondary surgery.

 

This sterile artificial skull model is an approximation of the average craniofacial anatomy, originating from data from up to 2000 analyzed CT scans. These scans were used to develop the matrix midface preformed orbital plates and the matrix mandible preformed reconstruction plates (Fig 2), launched in 2008 and 2009, respectively. The manufacturing material is polyphenylsulphone, which allows the skull to be steam sterilizable, reusable, cleanable, and biocompatible.

This new productthe sterile artificial skullcontributes to a more appropriate hard-tissue reconstruction in the CMF region, especially in cases of trauma, tumor, and craniofacial deformity. It provides a unique aid, always available and ready to use even in emergency cases.

Case 1: Camouflaging of deficient zygomatic prominences by mesh augmentation. a 19-year-old man with a typical-angle class iii appearance is shown preoperatively (fig 4a) and postoperatively (fig 4b). after preoperative planning, a bimaxillary osteotomy with advancement of the upper jaw and backwards movement of the lower jaw following bisagittal split osteotomy was performed. alternative options to augment the malar bone are surgical osteotomy of the malar bone with outwards movement of the zygomatic prominences, high le fort i osteotomy with onepiece movement of the maxilla together with the zygomatic prominence, using other biomaterials than meshes to augment these prominences. in this case, the average prominence in an adult caucasian patient was mimicked by contouring a 0.6 mm thick, 3-D mesh using the artificial skull.

Case provided by Nils-Claudius Gellrich, Hannover, Germany


Case 2: A 19-year-old woman had an extended sinunasal carcinoma in the right maxillary sinus area. fig 2 shows four views of the virtual preplanned computer-aided design; the reconstruction is represented in pink (fig 2a). The three remaining multiplanar views show the overlapping images of the virtual preplanned reconstruction (pink) and reconstruction result performed by using two individualized 3-D meshes (one for a three-wall-reconstruction of the orbit and one for reconstructing the right midfacial prominences).

Cases provided by Nils-Claudius Gellrich, Hannover, Germany

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