A baby girl born without part of her skull has undergone life-saving “innovative” surgery involving 3D printing technology.
The youngster from Rzeszów, Poland, has a birth defect that caused about a fifth of her skull to not form properly at the back of her head.
The deformity was missed on prenatal scans and doctors didn’t notice it until she was born in February.
It left exposed brain tissue that, if left untreated, left her susceptible to infections that would almost certainly prove fatal.
The doctors were given four days for the operation.
They were able to patch it up using skin and soft tissue from other parts of her body in an extremely gentle two-hour procedure.
The operation went flawlessly after medics visualized and practiced on an exact replica of the baby’s head.
They took detailed scans of her skull and sent them to a 3D printing company, which created a 1:1 replica.
A newborn baby girl’s life was saved by surgeons in Poland who were able to practice repairing her fractured skull using an exact 3D printed replica.
3D technology specialists Sygnis have created 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 give surgeons the widest possible options.” Pictured left: The technology company used selective laser sintering (SLS), a technique that involves fusing layers of nylon powder together, to create the first skull replica. Right: For the second model, they also used stereolithography (SLA), where photosensitive resins are cured layer by layer
WHAT IS ENCEPHALOCELE?
Encephaloceles are rare birth defects associated with skull defects caused by a partial lack of bony fusion leaving a gap through which part of the brain protrudes (protrudes).
In some cases, cerebrospinal fluid or the membranes that cover the brain (meninges) can also protrude through this gap.
The part of the brain that sticks out of the skull is usually covered by skin or a thin membrane, so the defect resembles a small pouch.
The protruding tissue can be located on any part of the head, but most often affects 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 encephalocele is unknown, but most likely the disorder results from a combination of several factors.
The incidence is rare, around 1.7 in every 10,000 births in the UK.
In most cases, the treatment of an encephalocele is a surgical procedure, in which the part of the brain that is outside the skull is returned to its place and the opening is closed.
Neurosurgeons can often repair even large encephaloceles without the child losing any further ability to function.
This allowed doctors to see the extent of bone loss for themselves and helped them plan surgery.
The operation offered only a temporary solution to her defect, preventing infection by closing the open part of the head.
In the future, he will need additional operations to reconstruct the missing bone, which will also use 3D printing technology.
Her bones are still growing, so doctors are waiting for the skull to develop further before performing reconstructive surgery.
The girl was born in February in a hospital in Rzeszów in the south-east of the country.
She was then transferred to a specialized children’s hospital 100 miles away in Krakow.
Experts in Krakow performed CT and MRI scans to create an accurate virtual model of her skull.
They uploaded the model to a computer and sent it to technical specialist Sygnis in the country’s capital, Warsaw, to be 3D printed using nylon and resins.
The print took 26 hours from start to finish, with two skulls produced at the same time and sent back to the surgeons University Children’s Hospital.
There, doctors used skulls to simulate a complex procedureas well as identify potential problems they would have to deal with during surgery.
The baby was kept isolated in an incubator to prevent infections in the brain. She was fed breast milk through a tube.
After analyzing the skulls and recording the exact shape and size of the defect, surgeons began a two-hour operation to reconstruct the soft tissue of the head.
The technique involved using skin, muscle and fat from other parts of her body.
Professor Łukasz Krakowczyk, who performed the operation, said: “This is a very rare defect and in my 20 years of experience it is the first time I have had to face such a procedure.
“It was a very innovative procedure for me. About a fifth of the skull surface was missing, so it was a very extensive defect.
“The operation had to be done quickly because a part of the brain was exposed that threatened to infect the central nervous system.
“A 3D printed model was used to plan the treatment.
“This allowed precise determination of bone loss, which greatly facilitated the planning and extent of surgery, thereby significantly reducing surgery time.”
The successful operation took place on February 28, but was only reported now. She will now have to undergo further treatment as her skull bones continue to develop.
Professor Karkowczyk said: “The child is awaiting another operation, this time to reconstruct the skull bone, but we know that the bones are growing, so we have to wait for this stage of the operation.
‘3D printing will also be indispensable in the reconstruction phase of the cranial bone defect, when it will be necessary to perfectly adapt and plan the reconstruction of the bone.’
Professor Łukasz Krakowczyk, who performed the surgery, said: “3D printing will also be essential in the reconstruction phase of the cranial bone defect, when it will be necessary to perfectly fit and plan the bone reconstruction”
The occipital bone, which forms the back and base of the skull, was not fully developed at birth.
Racing against time, the 3D printing team used two different technologies to “avoid the risk of failure and give surgeons the widest possible options.”
The technology company used selective laser sintering (SLS), a technique that involves bonding layers of nylon powder together, to create the first skull replica.
For the second model, they also used stereolithography (SLA), where photosensitive resins are cured layer by layer.
A Sygnis spokesman said: “The baby girl, who was due to appear in the world at any moment, did not have a 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 allow doctors to “predict the conditions they will face during a child’s surgery”.
The SLS model was accurate to 0.125mm detail and the company was able to produce it in a “relatively short print time”.
Sygnis said: “Once the printing process was complete, the SLS print went through a process of proper unbaked powder cleaning and sandblasting.
“We closed the whole project within 26 hours.”