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Chen X, Xu L, Yang Y, Egger J. A semi-automatic computer-aided method for surgical template design. Sci Rep. 2016; 6: 20280. pmid:26843434 Sharma, N.; Ostas, D.; Rotar, H.; Brantner, P.; Thieringer, F.M. Design and Additive Manufacturing of a Biomimetic Customized Cranial Implant Based on Voronoi Diagram. Front. Physiol. 2021, 12, 647923. [ Google Scholar] [ CrossRef] The serpent is a prominent symbol of temptation and evil. But that’s not its sole representation. The emblem of a snake can signify rebirth or transformation as well.
Wu, C.T.; Yang, Y.H.; Chang, Y.Z. Three-Dimensional Deep Learning to Automatically Generate Cranial Implant Geometry. Sci. Rep. 2022, 12, 1–10. [ Google Scholar] [ CrossRef] Winkler, P.A.; Stummer, W.; Linke, R.; Krishnan, K.G.; Tatsch, K. The influence of cranioplasty on postural blood flow regulation, cerebrovascular reserve capacity, and cerebral glucose metabolism. Neurosurg. Focus 2000, 8, 1–9. [ Google Scholar] [ CrossRef] of Oral and Cranio-Maxillofacial Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
Mesh Postprocessing
The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author. Author Contributions
Dewan, M.C.; Rattani, A.; Gupta, S.; Baticulon, R.E.; Hung, Y.C.; Punchak, M.; Agrawal, A.; Adeleye, A.O.; Shrime, M.G.; Rubiano, A.M.; et al. Estimating the Global Incidence of Traumatic Brain Injury. J. Neurosurg. 2018, 130, 1080–1097. [ Google Scholar] [ CrossRef] [ PubMed] Thiong’o, G.M.; Bernstein, M.; Drake, J. 3D printing in neurosurgery education: A review. 3D Print. Med. 2021, 7, 9. [ Google Scholar] [ CrossRef] [ PubMed] ii) Increasing voxel and pixel sizes. In some studies performed here, an increment in voxel and pixel sizes of the medical XCT dataset and laboratory XCT dataset was applied to improve the contrast of small structures such as the trabeculae of cancellous bone. To perform this process, pixel size was increased in medical XCT datasets of 512 × 512 pixels to 1,024 × 1,024 pixels (see Table 1, image matrix “processed”), using this path Image→Adjust→Size (Resize). For increasing voxel size (see Table 1, voxel size “processed”), using the same pathway for converting non-isotropic to isotropic voxel. We performed these processes in ImageJ ( Rueden et al., 2017) using the bicubic interpolation method ( Maret et al., 2012; Parsania and Virparia, 2016; Camardella et al., 2017; Rajarapollu and Mankar, 2017; Figure 5C). Increasing first the pixel size and then the voxel size is recommended. Meglioli, M.; Naveau, A.; Macaluso, G.M.; Orsi, M.; Barone, M.; Cucchi, A.; Cossellu, G.; Marchetti, C.; Masotto, N.; Panciera, A.; et al. 3D printed bone models in oral and cranio-maxillofacial surgery: A systematic review. 3D Print. Med. 2020, 6, 30. [ Google Scholar] [ CrossRef] Park, E.K.; Lim, J.Y.; Yun, I.S.; Kim, J.S.; Woo, S.H.; Kim, D.S.; Shim, K.W. Cranioplasty Enhanced by Three-Dimensional Printing: Custom-Made Three-Dimensional-Printed Titanium Implants for Skull Defects. J. Craniofac. Surg. 2016, 27, 943–949. [ Google Scholar] [ CrossRef] [ PubMed]Piitulainen, J.M.; Kauko, T.; Aitasalo, K.M.; Vuorinen, V.; Vallittu, P.K.; Posti, J.P. Outcomes of Cranioplasty with Synthetic Materials and Autologous Bone Grafts. World Neurosurg. 2015, 83, 708–714. [ Google Scholar] [ CrossRef] [ PubMed] Skull modify–This section loads the dataset once and handles its preparation. The user can apply transformations in form of rotation, translation, applying a transform matrix and much more. Further, the skull can be cut with a plane, where just one side of this plane will be visible. This option is necessary to get a view on the inner parts of the skull, for example, the inner edges. The output is a modified skull. Birk, H.; Demand, A.; Kandregula, S.; Notarianni, C.; Meram, A.; Kosty, J. Wound vacuum-assisted closure as a bridge therapy in the treatment of infected cranial gunshot wound in a pediatric patient: Illustrative case. J. Neurosurg. Case Lessons 2022, 3, 1–5. [ Google Scholar] [ CrossRef] World Health Organization. Injuries and Violence. Available online: https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence (accessed on 16 February 2023). In this contribution, we developed a planning prototype for 3D cranial implants within the freely available medical research platform MeVisLab ( http://www.mevislab.de/) [ 18]. To the best of our knowledge, this is the first time cranioplasty has been introduced to the MeVisLab platform. We decided for the semi-commercial platform MeVisLab, because it is currently more stable and user friendly than the pure open source platforms, like Slicer or the two MITK toolkits ( www.mitk.org/ and http://www.mitk.net/ from Germany and China). In summary, our method uses the mirrored skull as a template for generating a good fitting and aesthetic looking implant. Fitting in terms of no gaps between the bone and the implant. However, since surgeons have an interest in modifying the implants individually to a certain level, we did not design a fully-automated system performing all operations without any user interaction. Rather, the user can manually intervene in every step for specific modifications of the implant. Finally, the implant model can be stored as STL file to be used with 3D printing technology [ 19]. As audience for this contribution, we want primarily to target clinical/biomedical end users of our prototype. However, we also try to target researches that may want to build upon our solution. Thus, we also provide a more detailed technical description and code-sections like the paragraphs concerning the "Smoother module". We hope that the technical description makes it easier to understand the network/module and enables extensions for further features.
Lee MY, Chang C-C, Lin C-C, Lo L-J, Chen Y-R. Custom implant design for patients with cranial defects. Engineering in Medicine and Biology Magazine 2003; 21(2): 38–44. Replogle RE, Lanzino G, Francel P, Henson S, Lin K, Jane JA. Acrylic cranioplasty using miniplate struts. Neurosurgery 1996; 39(4): 747–749. pmid:8880768Gopi M, Krishnan S, Silva CT. Surface reconstruction based on lower dimensional localized Delaunay triangulation. Computer Graphics Forum 2000; 19(3): 467–478.
Antoniac, V.I.; Mohan, A.G.; Semenescu, A.; Doicin, C.V.; Ulmeanu, M.E.; Costoiu, M.C.; Cavalu, S.; Murzac, R.; Doicin, I.E.; Săceleanu, V.; et al. Cranial Implant with Osteointegration Structures and Functional Coating. Patent RO 132417, 30 October 2019. [ Google Scholar] In any acquisition from XCT systems, various artifacts may appear because of physical problems of the object, such as (i) a high density of the material, (ii) an excessive size of the object for the limits of the scanning envelope of the machine, and (iii) displacement of the object during the acquisition process or due to the inaccurate calibration of the machine (i.e., the parameters of acquisition used). Accordingly, the first step to follow is to review and to calibrate the images obtained to eliminate artifacts. The lignite mosaic stripes alternate with bands of bright blue turquoise and the eyes are made of two orbs of polished iron pyrite framed by rings made of white conch (Strombus) shell. The nasal cavity is lined with plates of bright red Spondylus (thorny oyster) shell. Parthasarathy J. 3D modeling, custom implants and its future perspectives in craniofacial surgery. Annals of Maxillofacial Surgery. 2014; 4(1): 9–18. pmid:24987592Singh, D.K.; Shankar, D.; Yadav, K.; Kaif, M.; Singh, R.K. Use of a Single Standard Skull Model for Preparation of PMMA-Based Cranioplasty Flap: A Novel Low-Cost Technique. Turk. Neurosurg. 2023. [ Google Scholar] [ CrossRef] Vitali, M.; Marasco, S.; Romenskaya, T.; Elia, A.; Longhitano, Y.; Zanza, C.; Abenavoli, L.; Scarpellini, E.; Bertuccio, A.; Barbanera, A. Decompressive Craniectomy in Severe Traumatic Brain Injury: The Intensivist’s Point of View. Diseases 2023, 11, 22. [ Google Scholar] [ CrossRef]
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