Single-step resection and reconstruction using patient-specific implants in the treatment of benign cranio-orbital tumors

J Oral Maxillofac Surg. 2013 Nov;71(11):1969-82. doi: 10.1016/j.joms.2013.03.021. Epub 2013 May 13.

Abstract

Purpose: The aim of this study was to evaluate surgical outcomes using patient-specific prostheses produced by computer-aided design and manufacturing for primary reconstruction in patients with benign cranio-orbital tumors. Polyetheretherketone was used to manufacture the implants.

Materials and methods: The present study included 3 patients who underwent fronto-orbito-pterional craniotomy using individual custom-made surgical guides. Patient-specific polyetheretherketone prostheses were used for reconstruction during the same surgery. All patients underwent esthetic examination (facial and orbital symmetry, globe projection and position), ophthalmologic examination (diplopia with the Hess-Lancaster test, visual field and acuity), and radiologic evaluations (computed tomography and magnetic resonance imaging) during the preoperative and follow-up periods. Operating time and short- and long-term complications were recorded.

Results: The immediate and long-term morphologic results were satisfactory; in particular, ocular globe position and projection were correct. After 25 to 31 months, none of the patients developed implant-related complications, such as infection, extrusion, or malposition. Two-year postoperative computed tomograms and magnetic resonance images showed no recurrences.

Conclusion: Single-step resection and reconstruction with computer-aided designed and manufactured implants is a challenging new technique that decreases operative time and morbidity. The implants adequately restore an anatomically complex area with satisfactory cosmetic results.

MeSH terms

  • Aged
  • Benzophenones
  • Bone Substitutes / chemistry
  • Computer-Aided Design*
  • Craniotomy / methods*
  • Diplopia / etiology
  • Eye / pathology
  • Female
  • Follow-Up Studies
  • Hemangioma / surgery
  • Humans
  • Ketones / chemistry
  • Male
  • Meningeal Neoplasms / surgery
  • Meningioma / surgery
  • Middle Aged
  • Operative Time
  • Orbit / pathology
  • Orbital Neoplasms / surgery*
  • Patient Care Planning
  • Plastic Surgery Procedures / instrumentation
  • Plastic Surgery Procedures / methods*
  • Polyethylene Glycols / chemistry
  • Polymers
  • Postoperative Complications
  • Prosthesis Design*
  • Prosthesis Implantation / instrumentation
  • Prosthesis Implantation / methods*
  • Skull Neoplasms / surgery*
  • Surgery, Computer-Assisted / methods
  • Treatment Outcome
  • User-Computer Interface
  • Visual Acuity / physiology
  • Visual Fields / physiology

Substances

  • Benzophenones
  • Bone Substitutes
  • Ketones
  • Polymers
  • polyetheretherketone
  • Polyethylene Glycols