Modifying the facial abnormalities in a patient with neurofibromatosis using 3D modelling and virtual surgery: A case report

Abstract

Neurofibromatosis is associated with various degrees of soft tissue and hard tissue involvement; among which tumor-related face ptosis is the main reason for serial exitional treatment. This case report demonstrates usage of analyzing mirror images technique for exact examination of abnormalities affecting one side of the face. The patient was a 48-year-old woman, diagnosed with VonRecklinghausen’s disease with numerous surgeries in the past, who was seeking surgical treatment for the mass on the left side of her face and modifying deformity.Materials and Methods: The procedure began with producing a 3D scan of patient’s face by a high quality laser scanner and the scanner data were transferred to relevant softwares andthen the postsurgical changes were applied to the patient’ face. Thereafter, using engineering and graphical softwares such as CATIA and SolidWorks, the necessary surgical molds were designed. In the next steps, the molds were built using a 3D scanner several sizes. During surgery, the templateswere first placed on the patient’s face in each phase and debulking was achieved based on the relevant template so that favorable amount of debulking was finally reached using these surgical guides.Conclusion: The simultaneous application of 3D surface laser scanner technology and reconstruction of the affected side based on the healthy side and analyzing the information obtainedfrom this reconstruction, make an objective assessment over the precise prediction of the abnormal soft tissue volume, pre- intra- and post-operatively which leads to improved results.Key words: Neurofibromatosis; 3D modeling; virtual surgery.