On the assets of CAD planning for craniosynostosis surgery

SkullWiz is a computer-aided design program that transforms computer tomogr aphic data of the neurocranium into a mathematical model that can be intera ctively manipulated to plan craniosynostosis surgery. Proper planning of th is 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, burri ng), and reference to the mechanical properties of calvarial bone at a give n age. With SkullWiz, infinite trials are possible to develop a surgical pl an that combines minimal action with maximum morphologic result. In contras t, 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. Valid ation of SkullWiz is difficult due to parameter variability. Its assets acr e therefore graphically exemplified in two common types of nonsyndromatic s ingle-suture craniosynostosis-trigonocephaly and anterior plagiocephaly. Sk ullWiz is one of the most accurate planning tools currently available for c raniosynostosis surgery. Accurate transfer of the planning by aluminium tem plates results in efficient and precise surgery by avoiding per-operative " chipping and fitting."