3-D Imaging in Cranial Facial Surgery

3-D Imaging in Cranial Facial Surgery in the Frank Hawkins Kenan Plastic Surgery Research Laboratories is a combined effort among researchers in Plastic and Reconstructive Surgery, Biomedical Engineering, and Radiology. The interests of this group are the applications of modern digital imaging technology to the practice and study of craniomaxillofacial surgery. Specifically, the lab is interested in quantitative imaging to establish severity and outcomes criteria for a variety of craniofacial conditions.  The quantitative 3-dimensional imaging techniques developed by the lab have been applied to the settings of facial trauma and to the development of a physiologic model for nasal physiology applicable to the practice of rhinoplasty.

 

 

The highlight of the lab's work, however, has been three-dimensional vector analysis (3DVA) for the study of craniosynostosis and related conditions. Preoperative and postoperative analysis of craniofacial morphology has previously relied on traditional anthropometric indices which are primitive. Three-dimensional vector analysis (3DVA) utilizes modern graphical software to analyze head CT scan information to form a 3D representation of skull morphology. Using a set of vectors emanating at prescribed angles from a predetermined single fixed point, 3DVA provides a finite, yet comprehensive, data-set of defined cranial surface points. The "cranial fingerprint" that is generated is a 3D representation of skull morphology is far more complex than can be represented by an interpretation of several measurements.

 

Comparison of craniosynostosis patients with age-matched data-sets from a normative database showed that 3DVA can detect a difference between normal and abnormal cranial morphology with a high degree of precision. When applied to preoperative CT imaging of the craniosynostosis patient, it enables automated analysis of diagnosis and severity. Comparison of preoperative data-sets to a normative database facilitates preoperative planning. Furthermore, postoperative data-sets can be either paired with the preoperative or normative data-sets to assess outcomes in a quantitative manner. The purpose of this project is the application of 3DVA to patients with craniofacial conditions.

 

The prerequisite of the 3DVA project is the development of a robust normative CT database. The database currently is one of the largest collections of pediatric cranial CT data in the world. The accruement of normative datasets is an ongoing project within the lab program.

 

Duke Plastic & Reconstructive Surgery

 

Srinivas Mukundan, MD, PhD

Harvard Brigham and Women's Radiology

Duke Biomedical Engineering

 

Duke Biomedical Engineering