3D skull library advances SA’s craniofacial unit

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By Belinda Willis

An important collection of 3D model skulls is growing in Adelaide as the state’s renowned craniofacial unit pursues world-leading technologies to transform lives.

Parents can now be shown skulls from the new library at the Women’s and Children’s Hospital to see common congenital problems first hand, making it easier to explain surgery on their babies, Australian Craniofacial Unit specialist Walter Flapper says.

“It’s obviously a stressful time and they can have a better understanding of what’s going on,” says Walter, one of the unit’s plastic and reconstructive surgeons.

“There are other advantages, it means we as surgeons can also hold the model and it helps us to visualise the problem we need to address, whether it’s a congenital problem or trauma.”

The 3D library gives the unit another important support tool as its surgeons operate on up to 45 babies a year to correct craniosynostosis that causes abnormal head shapes and can affect brain growth.

A 3D printed skull within the library at the Women’s and Children’s Hospital allowing parents to see common congenital problems first hand.

Whilst the unit has been using 3D printing to aid surgery for several years, it was only about a year ago that it began building the library with the skulls made using a 3D printer bought by the Royal Adelaide Hospital.

The process involves first taking a high tech scan of a patient’s skull. This incredibly accurate 3D imaging information is then used to program the printer that, in turn, uses a plastic compound rather than ink to print out a replica model.

Walter says it also means surgeons can study models of individual patient’s skulls to pre-plan surgery, can use the model to pre-bend titanium plates into the correct shape for an individual skull and even practice before surgery.

“It can be used as an educational tool for junior doctors and overall it means patients are not spending as long in surgery, it can help with more efficient operations and less anaesthetic use,” Walter says.

“This is of benefit as the longer the operation the higher the risk of complications.”

Surgeons are able to hold the model to help visualise the problem needed to address.

Models are also used in treating a wide range of other disorders across the unit’s two sites at the Women’s and Children’s Hospital in North Adelaide and Royal Adelaide Hospital in North Terrace where its patients are adults.

They include distortion of the skull and facial shape, cleft lip and palate deformities, facial growth anomalies, tumours requiring removal and reconstruction and trauma needing reconstruction of the head or jaw.

It is yet another tool for the unit that is well recognised internationally after being established in 1975 by craniofacial surgeon Professor David David. The unit is now a designated National Centre of Excellence and one of only two standalone craniofacial units in the world.

Founder Prof. David David was named 2018 South Australian of the Year, received the Companion of the Order of Australia in 1988 and in 1990 was named South Australian of the Decade in recognition of his work in the field.

“The unique thing about the unit is we are a standalone unit, others are linked to other surgery departments, and we work with children right through to older adults,” Walter says.

The Australian Craniofacial Unit team including specialist Walter Flapper, third from left.

He was drawn to the unit having finished medicine and surgical training in Auckland, New Zealand, then winning a fellowship post in Adelaide. After the placement he trained at the prestigious Oxford Craniofacial Unit in the United Kingdom for a year, before the return opportunity arose in the Adelaide unit in 2010.

“My initial plan was to come here for a year only to do the fellowship, then I was going to go back to New Zealand,” Walter says.

“The job came up here just as I finished up in the UK, we’d enjoyed our time here and the family liked it so we came back, and we’re still here. We have quite an international contingent of surgeons at the unit that came here and stayed.”

He lists the unit’s head Mark Moore as also being originally from New Zealand, specialist Peter Anderson is originally from the UK and visiting medical officer Vani Prasad Atluri from India.

The unit also operates on about 15 patients from overseas each year supported by charities and the State Government – and Walter travels regularly to Indonesia to help train local teams.

“I think we do pretty well considering the size of the city and the state, we punch above our weight, we have had strong overseas connections for quite some time and we train a number of people from overseas,” Walter adds.

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