Design of a custom-made cranial implant in patients suffering from Apert syndrome

This study defines a methodological procedure for the design and manufacturing of a prosthetic implant for the reconstruction of a midsagittal bony-deficiency of the skull due to the Apert congenital disorder. Conventional techniques for craniofacial defects reconstruction rely on the mirrored-image technique. When the cranial lesion extends over the midline or in case of bilateral defects, other approaches based on thin plate spline interpolation or constrained anatomical deformation are applied. The proposed method uses the anthropometric theory of cranial landmarks identification for the retrieval of a template healthy skull, useful as a guide in the successive implant design. Then, anatomical deformation of the region of interest and free-form modelling allow to get the customized shape of the implant. A full bulk and a porous implant have been provided according to the surgeon advises. The models have been 3D printed for a pre-surgical analysis and further treatment plan. They fulfilled the expectancies of the surgeon thus positive results are predictable. This methodology results to be reproducible to any other craniofacial defect spanning over the entire skull.