Computer guides facial reconstruction.

Holding a light pen, an aeronautical engineer begins to draw over a diagram illuminated on a video screen at McDonnell Douglas Corporation in St Louis. Slowly, a revised picture begins to take shape. But what emerges is not a part for high-performance aircraft. Instead the engineer is using the equipment to simulate craniofacial surgery. By rearranging sections of bone on a computerized three-dimensional (3-D) image of a skull, he is giving a normal appearance to the cranium of a child with a severe congenital anomaly. The engineer at the video console is Jim Warren, a unit director at McDonnell Douglas. His unlikely involvement in reconstructive surgery is the outgrowth of a collaboration with Michael Vannier, MD, assistant professor of radiology, and Jeffrey L. Marsh, MD, professor of plastic and reconstructive surgery, Washington University School of Medicine, St Louis. Together, under the auspices of the university's Edward Mallinckrodt Institute of Radiology,