A baby girl born without part of her skull underwent “innovative” life-saving surgery using 3D printing technology.
The youngster, from Rzeszow in Poland, has a birth defect which means around a fifth of her skull has not formed properly on the back of her head.
The deformity went undetected during pregnancy exams and was only noticed by doctors when she was born in February.
This left exposed brain tissue which, if left untreated, would have left her vulnerable to infections that would almost certainly prove fatal.
The doctors had four days to operate.
They were able to treat her using skin and soft tissue from other parts of her body in an extremely delicate two-hour procedure.
The operation went perfectly after the doctors visualized and practiced on an exact replica of the child’s head.
They took detailed scans of his skull and sent them to a 3D printing company who made a 1:1 copy.
A newborn baby girl’s life was saved by surgeons who were able to practice fixing her broken skull with an exact 3D-printed replica in Poland
Sygnis 3D technology specialists produced a three-dimensional prototype to help surgeons see the area of missing bone in real life. The team used two different technologies to “avoid the risk of failure and provide surgeons with the widest possible possibilities”. Pictured left: The tech company used Selective Laser Sintering (SLS), a technique that fuses layers of nylon powder together to form the first replica skull. Right: They also used stereolithography (SLA), where photoresists are cured layer by layer, for the second model
WHAT IS AN ENCEPHALOCELE?
Encephaloceles are rare birth defects associated with cranial malformations caused by a partial lack of bone fusion, leaving a space through which part of the brain protrudes (protrudes).
In some cases, cerebrospinal fluid or the membranes that cover the brain (meninges) may also protrude from this space.
The part of the brain that sticks outside the skull is usually covered with skin or a thin membrane so that the defect looks like a small sac.
Protruding tissues can be located on any part of the head, but most often affect the back of the skull (occipital region).
Most encephaloceles are large and significant birth defects that are diagnosed before birth.
However, in extremely rare cases, some encephaloceles may be small and go unnoticed.
The exact cause of encephaloceles is unknown, but the disorder most likely results from a combination of several factors.
Incidences are rare with around 1.7 in every 10,000 births in the UK.
In most cases, treatment for encephalocele involves surgery to reattach the part of the brain outside the skull and close the opening.
Neurosurgeons can often repair even large encephaloceles without the baby losing its ability to function further.
This allowed doctors to see for themselves the extent of bone loss and helped them plan the operation.
The operation only offered a temporary solution to his defect, preventing infection by closing the open part of his head.
She will need further surgeries to reconstruct the missing bone in the future, which will also use 3D printing technology.
His bones continue to grow, so doctors are waiting for the skull to grow more before doing the reconstructive surgery.
The girl was born in a hospital in Rzeszow, in the southeast of the country, in February.
She was later transferred to a specialist children’s hospital 100 miles away in Krakow.
Experts in Krakow took CT scans and MRIs to produce an accurate virtual model of his skull.
They downloaded the model to a computer and sent it to Sygnis technology specialists in the country’s capital, Warsaw, for 3D printing using nylon and resins.
The printing took 26 hours from start to finish, with two skulls made simultaneously to be sent back to surgeons at the Children’s University Hospital.
There, doctors used the skulls to simulate the complex procedureas well as identify potential problems they would face in surgery.
The baby was kept isolated in an incubator to prevent infections in his brain. She was fed with her mother’s milk through a tube.
After analyzing the skulls and noting the exact shape and size of the defect, surgeons began the two-hour operation to reconstruct the soft tissues of the head.
The technique involved using skin, muscle and fat from other parts of his body.
Professor Łukasz Krakowczyk, who performed the operation, said: ‘This is a very rare defect and in my 20 years of experience this is the first time I have had to deal with it. such a procedure.
“So for me it was a very innovative procedure. About a fifth of the surface of the skull was missing, so it was a very big defect.
“The operation had to be performed urgently because part of the brain was exposed, which threatened to infect the central nervous system.
“A model printed in 3D printing technology was used to plan the treatment.
“This enabled an accurate determination of bone loss, which greatly facilitated the planning of the operation and its scope, thus significantly shortening the duration of the operation.”
The successful operation took place on February 28 but has only now been reported. She will now have to undergo further treatment as her skull bones evolve.
Professor Karkowczyk said: ‘The child is waiting for another operation, this time the reconstruction of the skull bone, but we know that the bones are growing and that is why we have to wait for this stage of the operation.
“3D printing will also be indispensable at the stage of reconstruction of the bone defect of the skull, when it will be necessary to perfectly adapt and plan the bone reconstruction.”
Professor Łukasz Krakowczyk, who performed the operation, said: “3D printing will also be indispensable at the stage of skull bone defect reconstruction, when it will be necessary to perfectly adjust and plan the bone reconstruction »
The girl’s occipital bone – which forms the back and base of the skull – was not fully developed when she was born.
In a race against time, the 3D printing team used two different technologies to “avoid the risk of failure and offer surgeons the widest possible possibilities”.
The tech company used Selective Laser Sintering (SLS), a technique that fuses together layers of nylon powder, to form the first replica skull.
They also used stereolithography (SLA), where photoresists are cured layer by layer, for the second model.
A Sygnis spokesperson said: “The girl who was about to appear into the world at any time had no shaped occipital bone, which meant that the brain tissue was partially exposed.
“Both SLS and SLA technologies are characterized by high precision and detail, which is essential in the case of anatomical models.”
The models were created in record time to enable doctors to “predict the conditions they would face during the child’s operation”.
The SLS model was accurate to within 0.125mm of detail and the company was able to produce it in “a relatively short print time”.
Sygnis said, “After the printing process was completed, the SLS technology print underwent a proper cleaning process of unbaked powder and sandblasting.
“We completed the entire project in 26 hours.”