J Craniofac Surg. 2025 Nov 17. doi: 10.1097/SCS.0000000000012204. Online ahead of print.
ABSTRACT
Virtual surgical planning (VSP) has revolutionized craniofacial surgery by enhancing preoperative planning and surgical precision, though its optimal applications in pediatric cases remain incompletely defined. The purpose of this study is to evaluate the evolution and expanding applications of VSP in craniomaxillofacial surgery at our tertiary pediatric hospital. A retrospective review of index craniofacial procedures performed between 2011 and 2023 at a tertiary pediatric hospital was conducted, analyzing VSP utilization, including the use of stereolithographic models, cutting guides, splints, and patient-specific implants. Demographic data, operative times, and surgical outcomes were collected for all procedures. During the study interval, 2112 index craniofacial procedures were performed, of which 19.9% (n=420) cases were virtually planned. Virtual surgical planning was most frequently used in orthognathic operations (n=284, 67.6%). From 2011 to 2014, VSP was solely applied to orthognathic and midface cases, with the addition of box osteotomies for hypertelorism in 2015, cranioplasties in 2016, anterior vault advancements in 2019, and posterior/middle vault expansions in 2021. The use of patient-specific implants significantly decreased operative duration in bimaxillary orthognathic cases compared with traditional fixation methods (207.5 min versus 234.0 min, P=0.021). Virtual surgical planning has become integral to pediatric craniofacial procedures requiring high precision or involving complex anatomy, though its utility is currently limited in operations where cranial growth must be considered. As 3D analysis software and manufacturing advances, VSP may find broader applications in pediatric craniomaxillofacial surgery.
PMID:41248445 | DOI:10.1097/SCS.0000000000012204
