Craniofacial surgery is a term used to describe a variety of surgical procedures used in the treatment of patients with anomalies in the structure of the face, jaws and skull. For some people these anomalies may be congenital (present from birth) and for others they may be acquired due to trauma or cancers.
The goal of any craniofacial surgery is to restore the form and function of the individual’s head shape and structure so that they can lead normal and full lives.
The use of Computer Technology and 3D modelling in Craniofacial Surgery
The modern revolution of personalised surgery revolves around the use of computer technology to assess, develop and design individualised patient specific surgeries. It is an exciting time to work in this space as the use of 3D scanning and patient specific 3D manufactured implants and guides are expanded into new and novel applications. Dr Rtshiladze has embraced these technological advances in craniofacial surgery and is performing regular and large volumes of these cases.
This technology revolves around the use of computer-based 3D scanning and modelling of the patient’s skull. This model is then used to plan the procedure in a step-by-step fashion. Termed ‘Virtual Surgical Planning’ (VSP), the operation is simulated inside the computer by cutting and moving 3D models of the patient’s face and skull around. This allows the surgeon to perform the same operation in multiple ways and try different approaches endlessly until the best possible result for the patient is achieved. Once the virtual plan is made, 3D printing technology is then used to produce before and after models, personalised cutting guides, plating jigs and patient specific implants. In this very personalised way, Dr Rtshiladze can design an ideal operation for any given patient with their individual craniofacial issue.
There are many advantages to using VSP when planning craniofacial surgeries. These include improved aesthetic results; anticipating potential operative problems before they occur; trying different designs to find the best fit for the patient and ultimately saving time in the operating room which reduces patient risk of infection and other adverse events.
Where appropriate, these technologies are employed by Dr Rtshiladze across both the adult and paediatric craniofacial populations. It is an exciting landscape to be an early adopter at the forefront of using these techniques to improve outcomes for our patients.
What to expect at a Paediatric Craniofacial appointment
Craniofacial conditions in children are notoriously complex due to the developing structures of the child’s head shape and associated soft tissues. Children are often assessed in the first months of life at a time when parents are adjusting to having a new baby in the house and are dealing with some pretty challenging and sleep deprived times! Understandably parental levels of concern can be high following discussions about the possible diagnosis of a craniofacial condition affecting their child. It is not uncommon for children to see a number of doctors, nurses and midwives before they attend a craniofacial appointment. This can lead to a lot of confusion about these rarer conditions, whether the correct diagnosis has been made or what the significance of the diagnosis may be. Many times, children who present for a craniofacial review are in fact completely happy, healthy and normal children without any craniofacial problems.
A paediatric craniofacial appointment with Dr Rtshiladze begins with a careful discussion with the parents about the child’s history. An examination of the child’s head shape is then performed and some key measurements are taken. Whilst scans and radiological imaging are not required prior to the appointment, if you have had any done please bring the reports and images with you on the day. Dr Rtshiladze has operated on many younger patients with significant craniofacial issues. Whilst each child has their own specific condition with its own challenges, the experience and concerns faced by families are often similar. One such family were brave enough to share their experience with the broader community. Their story can be found here https://www.schn.health.nsw.gov.au/news/articles/2020/12/virtual-surgery-remodelling-craniofacial-operations
Craniofacial surgery requires a multidisciplinary approach and the success of the treatment hinges on the involvement of many other clinicians. For this reason, decisions about craniofacial surgery are never made by a single surgeon. However, the opportunity for Dr Rtshiladze to meet with parents and children prior to attendance at the MDT may speed up that process. Perhaps more importantly it is a chance to allay parental concerns through providing accurate and correct information about craniofacial conditions relevant to the child. You can find more information about craniofacial services at the Sydney Children’s Hospital, Randwick Craniofacial page (https://www.schn.health.nsw.gov.au/find-a-service/health-medical-services/craniofacial/sch)