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Background: Single-stage surgical correction of Crouzon syndrome aims to remodel the cranial vault to achieve a morphology approaching age-matched norms. Virtual surgical planning (VSP) and computer-aided design (CAD) technology are recently used in craniofacial surgery. We aimed to determine the value of 3D planning tools and VSP in guiding different steps of surgical correction in craniofacial deformities in patients with untreated Crouzon syndrome. Methods: This study included three patients with delayed presentation of untreated Crouzon syndrome who underwent cranial vault remodeling preoperatively guided by VSP techniques between Jan 2021 and Feb 2023. Preoperative evaluation included all patients' physical examinations and 3D computed tomography (CT) scans. The constructed 3D files from the CT data were subsequently used for preoperative measurements. DICOM files of both preoperative and postoperative data were introduced into the medical 3D software. Results: The patients' ages at surgery were 18, 20, and 23 years. All patients had satisfactory aesthetic and functional outcomes with no major complications. The average operative time was 8.35 ± 2.53 hours. There was an improvement regarding cephalometric analysis and orbital morphology. The Presimulation movement distance regarding the frontal and zygomatic bone advancement showed a significant increment with a degree of overcorrection, significantly different from the preplanned. Conclusion: In conclusion, VSP is revolutionizing the surgical approach to complex craniofacial and occlusal malformations. This study successfully reports the use and applicability of VSP in untreated adult patients in a single stage. Combining the surgeon's experience and the appropriate use of computer-assisted surgery ultimately leads to successful surgery.

Background Data: Open lumbar microdiscectomy has been considered the gold standard in the management of lumbar disc herniation (LDH) because of its favorable outcomes in long-term follow up. Nowadays, minimally invasive discectomy is gaining recognition due to its advantages. The advantages endoscopic lumbar discectomy includes clear visualization, less injury to the paraspinal muscle, protection of spinal stiffness and dynamic structure better cosmetic effect, and less postoperative symptoms and open surgeryrelated complications with subsequent earlier return to work. Purpose: This study was conducted to evaluate the efficacy of transforaminal and interlaminar endoscopic lumbar discectomy in the treatment of lumbar disc prolapse. Study Design: A prospective descriptive case series study. Patients and Methods: A prospective descriptive case series study was carried out on 42 patients who had lumbar disc herniation not responding to medical treatment for 6 months. Patients included from those attending the neurosurgical department of Alexandria University, Sohag University Hospital, and Menonfya University; in the period from January 2012 to February 2015. All patients underwent either transforaminal or interlaminar endoscopic lumbar discectomy. Results: All patients had significant improvement in VAS score. According to Mac Nab's criteria; 79% of patients have excellent results and 11% have good results; thus giving about 90% satisfactory outcome. Out of the 25 patients undergone interlaminar approach, 24 (96%) had completed the planned operative procedure. On the other hand, out of the 17 patients who undergone transforaminal approach; only 12 patients (70.6%) had completed the planned operative procedure. Conclusion: Pure endoscopic discectomy is an effective surgical method for treatment of lumbar discprolapse. (2016ESJ104)