03 November 2017

Skully proves a model for life-saving surgery

It is not the sort of thing you’d expect to find on a newborn’s dressing table but in Sophia Seidel’s bedroom the model of a human skull, slightly larger than a tennis ball, takes pride of place atop a nest of cuddly pink toys.

But “Skully”, as the plastic model is affectionately known by Sophia’s parents Brooke and Demian, is more than just some quirky ornament. It is an exact replica of the skull of the younger of their two daughters – and two months ago it helped save her life. In what is believed to be a WA first, the model – 3D-printed by Royal Perth Hospital biomedical engineers from scans of Sophia’s skull – was used to prepare for the extremely delicate operation.

Though it was not known at the time, Sophia was born with a mixture of bone and soft tissue blocking the back of her nasal passage.

Because babies don’t breathe through their mouths until they are about a year old, Sophia was unable to breathe independently and had to be resuscitated twice within minutes of her birth.

While doctors searched for the cause of the newborn’s difficulties, an artificial airway was inserted into her mouth to encourage mouth breathing.

But it was not until a scan of her head was taken two days later that Sophia’s nasal obstruction was discovered.

Fixing it would involve surgery to remove the extraneous tissue, and Princess Margaret Hospital ear, nose and throat consultant surgeon Jenn Ha knew it would be an extremely delicate procedure.

“With such a tiny baby, I knew the instruments that we would normally use for this sort of an operation would be too big,” she explained.

“I could fit Sophia’s head in the palm of my hand – and I don’t have big hands!

“Being able to go into the operation knowing I had the right instruments was going to be really important.”

Dr Ha was aware that Royal Perth Hospital biomedical engineers had the ability to create 3D models of skulls using patient CT scans and so four days after Sophia’s birth, she contacted them to request a model of Sophia’s skull.

The engineers got to work on it immediately and within three days “Skully” was ready for collection.  Of the hundreds of cases the Royal Perth Hospital engineering team has worked on, this was by far their youngest patient.

Dr Ha says that as well as helping her prepare for Sophia’s surgery at Princess Margaret Hospital, it also helped her prepare Sophia’s parents for the procedure.

“Sophia’s parents were understandably apprehensive about the operation so having the model to help show them what I would be doing, made a big difference,” she said.

Dr Ha operated on Sophia with instruments normally used for ear surgery but says had she not had the model, she might not have had those available in theatre.

“If we’d had to search for alternative instruments during the procedure it could have increased the duration of the surgery,” she said.

“And that would have meant Sophia spending longer under general anaesthetic.”

Dr Ha says having had the model helped the operation at Princess Margaret Hospital to run smoothly and believes it was the first time a 3D model had been used to help prepare for this kind of ENT surgery in Perth.

She believes 3D modelling has enormous potential to be used in the surgical field.

“I think it can be really a helpful tool for explaining a procedure to parents, especially when you are seeking their consent to operate,” she said.

She also believes it could be of value in helping junior doctors gain proficiency in various procedures.

Sophia’s surgery – at just nine days old – was a success and she is now breathing independently and putting on weight.

Brooke Seidel says she and her husband cannot speak highly enough of Dr Ha and her registrar Dr Allison Reid, who they say went above and beyond for their family.

“They were amazing,” Mrs Seidel says.

“They were on call for us even when they weren’t on call and they made the whole thing as easy as could be for us.”

The Seidels said they were also grateful to the engineers at Royal Perth Hospital who made Skully in time for Sophia’s operation and to the midwives at King Edward Memorial Hospital birthing centre, where Sophia was born, and the nurses and doctors at KEMH and PMH.


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