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

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

Acta Neurochir (Wien). 2017 Jan 10;:

Authors: Carolus A, Weihe S, Schmieder K, Brenke C

Abstract
INTRODUCTION: Cranial defects following intra-osseous tumor removal may be large and require adequate reconstruction. CAD/CAM implants have been used for years to achieve an optimal cosmetic result. The disadvantage is that such implants require a second surgery. A preoperative virtual planning of resection margins and the simultaneously fabrication of the cranioplasty could be a possibility to subsume the steps tumor resection and cosmetic restoration to a single procedure.
METHODS: We present two cases of patients with complex intra-osseous spheno-orbital meningioma. Tumor resection was performed with the help of a drilling template in form of a frame. The template also served as a negative for the computer-designed cranioplasty. The devices were manufactured by DMD GmbH - Digital Medical Design/DDI-Group, Dortmund, Germany.
DISCUSSION: The usage of the template was highly practicable. Small adjustments in bone removal were necessary to achieve an optimal fitting of the implant. The 6-month follow-up showed for one patient a good and for one a satisfactory cosmetic result. No second surgery was necessary.
CONCLUSIONS: 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.

PMID: 28074281 [PubMed - as supplied by publisher]

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