Three-dimensional surgical planning and simulation to improve surgical accuracy and reduce invasiveness of cranioplasties.

Patients with too large a frontal prominence may suffer discomfort and subsequent self-esteem problems. The case of a 29-year-old male with a prominent forehead is presented. After three-dimensional (3D) virtual simulation of the procedure, a stereolithographic model of the skull and a surgical cutting guide were fabricated. The forehead recontouring and reconstruction procedure was performed under general anaesthesia and the postoperative course was uneventful. At the 12-month postoperative follow-up, clinical and radiographic documentation confirmed softening of the frontal prominence from 14.48mm to 8.56mm, a nasofrontal angle increase of 22°, and overall high patient satisfaction. The proposed workflow results in greater surgical precision, shorter reconstruction times, reduced patient morbidity due to a reduced risk of dural exposure and postoperative infection, and overall higher predictability and patient satisfaction.