One-step CAD/CAM titanium cranioplasty after drilling template-assisted resection of intraosseous skull base meningioma: technical note

Carolus, Anne; Weihe, S.; Schmieder, Kirsten; Brenke, Christopher

doi:10.1007/s00701-016-3053-4

Cited by 23 publications

(19 citation statements)

References 6 publications

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“…In 2017, Carolus et al presented two patients with intraosseous skull base meningiomas that underwent tumor resection and one-step cranioplasty with a customized CAD/ CAM titanium implant. 17 The authors reported a good fitting of the implants and satisfactory cosmetic results. Gerbino et al reported good morphological outcome using customized polyetheretherketone (PEEK) implants in three patients with fronto-orbito-pterional craniotomy for intracranial lesions.…”

Section: Discussionmentioning

confidence: 86%

Single-Step Resection of Sphenoorbital Meningiomas and Orbital Reconstruction Using Customized CAD/CAM Implants

et al. 2019

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Objective Computer-aided design and manufacturing (CAD/CAM) implants are fabricated based on volumetric analysis of computed tomography (CT) scans and are routinely used for the reconstruction of orbital fractures. We present three cases of patients with sphenoorbital meningiomas that underwent tumor resection, orbital decompression, and orbital reconstruction with patient specific porous titanium or acrylic implants in a single procedure. Methods The extent of bone resection of the sphenoorbital meningiomas was planned in a virtual three-dimensional (3D) environment using preoperative thin-layer CT data. The anatomy of the orbital wall in the resection area was reconstructed by superimposing the contralateral unaffected orbit and by using the information of the neighboring bony structures. The customized implants and a corresponding craniotomy template were designed in the desired size and shape by the manufacturer. Results All patients presented with a sphenoorbital meningioma and exophthalmos. After osteoclastic craniotomy with the drilling template, orbital decompression was performed. Implant fitting was tight in two cases and could be easily fixated with miniplates and screws. In the third patient, a reoperation was necessary for additional bone resection, as well as drilling and repositioning of the implant. The postoperative CT scans showed an accurate reconstruction of the orbital wall. After surgery, exophthalmos was substantially reduced and a satisfying cosmetic result could be finally achieved in all patients. Conclusions The concept of preoperative 3D virtual treatment planning and single-step orbital reconstruction with CAD/CAM implants after tumor resection involving the orbit is well feasible and can lead to good cosmetic results.

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Section: Discussionmentioning

confidence: 86%

Single-Step Resection of Sphenoorbital Meningiomas and Orbital Reconstruction Using Customized CAD/CAM Implants

et al. 2019

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“…The one-step template-assisted resection of bone tumor following cranioplasty has been already reported in the cases of including fibrous dysplasia and intraosseous meningiomas (7,8,11). This method looks promising for intraosseous tumors compared with other modalities, such as intraoperatively modeling an artificial bone flap without a template (1,12) or manufacturing the custom-made implant based on the stereolithographic model ( 13).…”

Section: Discussionmentioning

confidence: 99%

“…To improve the precision of surgical resection and reconstruction procedures, computer pre-operative planning and intraoperative navigation can be used (4)(5)(6). The next step is performing a one-step template-assisted resection of bone tumor following a cranioplasty with the PSI based on the virtual planning of the resection margins, which has already been reported in the cases of fibrous dysplasia and intraosseous skull base meningiomas (7,8).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Simultaneous Resection of Bone Tumor and CAD/CAM Titanium Cranioplasty in Fronto-Orbital Region

et al. 2021

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Background: Simultaneous resection of bone tumors in the fronto-naso-orbital region is a great challenge due to the need for adequate reconstruction of the facial skeleton. Pre-operative virtual planning of resection margins and the simultaneous fabrication of the cranioplasty using computer-aided design/computer-aided manufacturing (CAD/CAM) technology could allow combining the tumor resection and cosmetic restoration steps into a single procedure.Methods: We present five consecutive cases of patients with bone tumors of the fronto-naso-orbital region. The indications for surgery included: (1) the presence of a major cosmetic defect; (2) progressive tumor growth. The histological examination revealed vascular malformation, hemangioma, and fibrous dysplasia in two cases. Tumor resection was performed with the help of a drilling template in form of a tumor. The computer-designed cranioplasty formed based on the non-involved side of the skull of the patient was manufactured. In one patient, the reconstruction was performed using two separate implants.Results: The position of the implant fits in with pre-operative planning in two cases; in those cases, the additional trimming of the implant or bone defect was required. Good cosmetic outcomes were noted in all patients, and no complications occurred. No repeat surgery was necessary. The template has proved to have high application potential.Conclusion: Simultaneous resection and CAD/CAM cranioplasty in the case of bone tumors in the fronto-orbital region is a promising technique with the aim of minimizing operation time and achieving a good esthetic outcome.

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“…Bone cutting guides or a drilling template were used for tumor resection. [ 24 25 ] Duraplasty using artificial dura was applied for broad dural defects. Moreover, decompressive craniectomy is a well-established concept for traumatic injury to reduce intracranial pressure that improves survival in the clinical settings.…”

Section: Discussionmentioning

confidence: 99%

Giant intraosseous meningioma associated with calvarial hyperostosis and subcutaneous invasion: Case reports and literature review

et al. 2021

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Most meningiomas grow intracranially, and primary intraosseous meningioma is rarely reported. We present two rare surgical cases of giant intraosseous meningothelial meningioma. The first patient was a 35-year-old male with parietal skull deformity without neurological symptoms. Total resection was successful. The origin was the parasagittal intraosseous layer, and the superior sagittal sinus was partially opened. The second patient was a 20-year-old female with a slightly upward protrusion of the frontal skull without pain or neurological deficits. The lesion was totally resected, and the origin was the parasagittal intraosseous layer invading into the dura matter and subcutaneous layer. The clinical management of these cases presented a surgical challenge because of detachment and repair from venous sinuses. The current report provides surgical tips for such rare diseases and is a good reference for the future treatment of similar diseases.

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One-step CAD/CAM titanium cranioplasty after drilling template-assisted resection of intraosseous skull base meningioma: technical note

Abstract: Drilling template application could contribute to challenging cases of large fronto-basal meningiomas with the aim of minimizing operation time and achieving a good esthetic outcome.

Cited by 23 publications

References 6 publications

Single-Step Resection of Sphenoorbital Meningiomas and Orbital Reconstruction Using Customized CAD/CAM Implants

Single-Step Resection of Sphenoorbital Meningiomas and Orbital Reconstruction Using Customized CAD/CAM Implants

Case Report: Simultaneous Resection of Bone Tumor and CAD/CAM Titanium Cranioplasty in Fronto-Orbital Region

Giant intraosseous meningioma associated with calvarial hyperostosis and subcutaneous invasion: Case reports and literature review

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