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Virtualplanning774simulatedduringthevirtualplanningWithadeflectionpointalittleleftfromthemidlineofthenasionthesymmetryoftheorbitalregioncouldberestoredTheforeheadwasreconstructedonthenewlycreatedorbitalbarBysimulatingthefinalreconstructiontheosteotomiescouldbeoptimizedandgapsbetweenthecranialsegmentsminimizedA)frontalviewoftheplannedosteotomiesB)topviewshowingtherightorbitaladvancement(red)C)topviewwithasimulationoftheforeheadreconstructionTheseexamplesshow thatdue toindividualdifferencespatient-specificsolutionsaredesiredandthataconventionalorstandardapproachisnotalwaysthebestmatchforapatientNeverthelesstheplanningprocessoftenbeginswiththeelaborationofcommonand/orstandardreconstructionstrategiesBysimulatingdifferentscenariositcanberuledoutthatthereisstillasolutionthatcouldworkbetterFromourexperiencethefirstscenariothatisvirtuallyexploredrarelyturnedouttobethebestfittingstrategywhichunderliestheimportanceoftestingdifferentstrategies2-PLANNING WITHREFERENCE VALUESDetailedinformationconcerningthenormalshapeanddevelopmentofthecraniumisavailablefromtheliteratureandresearch6 Volumesratios2D-and3Dmeasurementscanbeusefulduringtheplanningofopenreconstructions ThesemeasurementsprovideadetailedinsightintowheretheabnormalityismostprominentandwhichpartoftheskullwillbenefitmostfromacorrectionForexamplereferencemeasurementssuchastheinterorbitaldistanceandtheanglebetweenorbitaeandnasionserveasguidelineswhentheorbitaladvancementisvirtuallyreconstructed(Figure3)67Figure3Duringthevirtualplanningofatrigonocephalypatientmeasurementscanbeperformedandreferencevaluescanbeconsulted
