Preoperative planning of craniectomy and reconstruction using three–dimension-printed cranioplasty for treatment of calvarial lesion

Q3 Medicine
Md. Rezaul Amin, K. T. Islam, Moududul Haque
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引用次数: 0

Abstract

Common calvarial lesions include fibrous dysplasia (FD), intraosseous meningioma, osteoma, Langerhans cell histiocytosis (LCH), intraosseous hemangioma, dermoid and epidermoid cyst, and malignancy. Surgical removal with removal of the involved skull is the choice of treatment for these lesions. Previously, the skull defect was repaired using allograft, and alloplastic materials have been replaced with newer polyetheretherketone (PEEK) material, which is more resistant, biocompatible, and can be 3-dimension (3D)--printed. High-resolution 3D printing uses very fine extruders to put materials in fine layers to recreate patients’ anatomy authentically, which gives superior cosmetic outcomes. Our objectives were preoperative planning of craniectomy and reconstruction for calvarial lesions and reconstruction of skull defects using 3D-printed cranioplasty with PEEK materials. In this series, we describe 11 cases in which skull lesions were removed and reconstructed in the same sitting using a 3D-printed PEEK implant designed preoperatively using high-resolution computer tomography. All the cases were done in the neurosurgery department of Bangabandhu Sheikh Mujib Medical University from 2021 to 2023. Patients were followed up for 6 months after surgery. Regarding 11 cases, six cases were FD, three cases were intraosseous meningioma, one case was intraosseous hemangioma, and one case was LCH. Average lesion size were 12.73-5.77 cm. Cranioplasty was done with PEEK material. Minor complications were treated conservatively. Seroma, postoperative fever, and nausea were among these. The human bone-like biocompatibility and resistance to physical forces leads to more frequent use of PEEK, which enables to repair of complex craniofacial defects with better cosmesis. Despite some limitations, the PEEK cranioplasty implant continued to thrive and showed its promise to be an excellent material. Further, research and investment should be put into developing the technique.
利用三维打印颅骨成形术治疗颅骨病变的颅骨切除和重建术前规划
常见的颅骨病变包括纤维发育不良(FD)、骨内脑膜瘤、骨瘤、朗格汉斯细胞组织细胞增生症(LCH)、骨内血管瘤、皮样囊肿和表皮样囊肿以及恶性肿瘤。手术切除受累颅骨是治疗这些病变的首选方法。以前,颅骨缺损使用异体移植进行修复,现在异体材料已被更新的聚醚醚酮(PEEK)材料取代,这种材料更耐磨、生物相容性更好,而且可以进行三维(3D)打印。高分辨率三维打印使用非常精细的挤出机将材料分层打印,以真实再现患者的解剖结构,从而达到更佳的美容效果。我们的目标是术前规划颅骨切除和颅骨钙化病变的重建,以及使用3D打印的PEEK材料颅骨成形术重建颅骨缺损。所有病例均于 2021 年至 2023 年在班加班杜谢赫-穆吉布医科大学神经外科完成。11例患者中,6例为FD,3例为骨内脑膜瘤,1例为骨内血管瘤,1例为LCH。病灶平均大小为 12.73-5.77 厘米。使用PEEK材料进行了颅骨成形术。对轻微并发症采取了保守治疗。PEEK材料具有与人体骨骼相似的生物相容性和抗物理力的能力,因此被越来越多地用于修复复杂的颅面缺损,并具有更好的外观效果。尽管存在一些局限性,但 PEEK 颅骨成形术植入体仍在不断发展壮大,并有望成为一种优秀的材料。应进一步研究和投资开发这种技术。
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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
623
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