Fronto-naso-orbital Reconstructions

Chen, Shih‐Heng; Ko, An-Ta; Chen, Hung-Chi; Roan, Tyng–Luen; Tang, Yueh-Bih

doi:10.1097/sap.0000000000001606

Cited by 4 publications

(9 citation statements)

References 8 publications

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“…PEEK has become a favorable alternative for craniofacial reconstruction attributing to its perfect histocompatibility, excellent deformability, thermoplastic and ideal radiographic features since firstly reported by Scolozzi in 2007 [ 14 ] in a patient with gunshot fronto-temporal defect that had failed reconstruction with TM and methylmethacrylate. [ 2 – 4 , 8 , 9 , 11 , 13 ] CAD–CAM is an emerging technology that has been used in recent years for cranioplasty of various materials. [ 1 , 3 , 14 , 15 ] In this study, we innovatively used this technique, combined with virtual surgical planning and intraoperative navigation, to perform 2 reconstructions of cranial defects of different etiologies in the fronto-orbital region using PEEK implants.…”

Section: Discussionmentioning

confidence: 99%

“…[1,9,10] Traditionally, autologous bone grafting remains a good reconstructive option for small single defects with irreplaceable histocompatibility, However, in the forehead-midfacial region, larger reconstructions not only lead to increased donor site morbidity and bone resorption, but also reduce the strength and plasticity of the aesthetic contour. [2,[5][6][7][8][9]11] TM and polymethyl methacrylate can provide good morphological results with computer assisted procedures, but nevertheless, preoperative or intraoperative bending and correction, and sometimes even excision to adjust the shape of periorbital ridges, especially in the orbit, is time-consuming and still difficult to accomplish. [5,12,13] The correct placement of the implant and the conformity of its size and shape to the individual anatomy of the damaged structure are critical to the overall success of fronto-orbital reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Traditional materials and techniques commonly used for frontoorbital reconstruction include autologous bone grafts, titanium mesh (TM), polymethyl methacrylate, and hydroxyapatite in primary or second operation. [1,2,4,5] Each material certainly has its advantages and yet, inevitably they are restricted to some distinct disadvantages, such as unpredictable resorption rates of autologous bone grafts, lack of contourability, poor plasticity, incompatibility, complex installation, and incorrect implant placement. [1][2][3][4][5][6][7] In the past decade, computer-assisted designed and computerassisted manufactured (CAD-CAM) prostheses have been increasingly used in the medical field with the research and development of new biomaterials and computational threedimensional (3D) rapid prototyping technologies.…”

Section: Introductionmentioning

confidence: 99%

“…Cranial defects in the fronto-orbital region may be due to a variety of different pathologies, such as intracranial/extracranial infections, tumor surgery, or cranio-facial trauma settings [1–3] . Traditional materials and techniques commonly used for fronto-orbital reconstruction include autologous bone grafts, titanium mesh (TM), polymethyl methacrylate, and hydroxyapatite in primary or second operation [1,2,4,5] .…”

Section: Introductionmentioning

confidence: 99%

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Reconstruction for diverse fronto-orbital defects with computer-assisted designed and computer-assisted manufactured PEEK implants in one-stage operation

Yang

Cheng

2021

Medicine

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Rational: Reconstruction of complex craniofacial defects in fronto-orbital region has been reported to be extremely few. In this study, we report 2 cases with fronto-orbital defects of different etiologies in one-stage surgical reconstruction with polyetheretherketone (PEEK) prosthesis using computer-assisted design and computer-assisted manufactured (CAD–CAM) techniques. Patient concerns: One patient was a 49-year-old man, who admitted with a depressed and comminuted fracture in the left fronto-orbital region as a result of a motor vehicle collision. The other patient was a 45-year-old woman who was hospitalized with an unexpected diagnosis of a fronto-orbital bone tumor during a head CT examination in a minor traumatic brain injury. None of them had a significant past medical history. Diagnoses: The first patient's head computed tomography (CT) showed multiple depressed comminuted fractures in the right fronto-orbital region with localized frontal lobe contusion, and the diagnosis was clear when combined with the mechanism of traumatic head injuries. The second patient's head CT and magnetic resonance image suggested a right lateral orbital neoplastic lesion that distorted peripheral bone, the postoperative pathological examination demonstrated an osteoma with fibromatous hyperplasia, and thus the women's diagnosis was confirmed. Interventions: A three-dimensional image of both patients’ skull bone were collected from a high-resolution CT. A virtual surgical planning for lesion excision and defect remodeling based on CAD–CAM techniques was undertaken, and than the reconstruction surgery was performed in a single procedure using PEEK prosthesis. Antibacterial treatment was prescribed routinely. Outcomes: Postoperatively, both patients achieved excellent aesthetic restoration as well as functional recovery of the orbital cavity without neurological or infectious complications during an average 22 months follow-up. Lessons: The CAD–CAM PEEK implants could be a preferred option for reconstruction of patients with various complex fronto-orbital defects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reconstruction for diverse fronto-orbital defects with computer-assisted designed and computer-assisted manufactured PEEK implants in one-stage operation

Yang

Cheng

2021

Medicine

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“…The adequate reconstruction of facial contours after craniofacial traumas is a great challenge due to the unique sophisticated spatial complexity of this region (3). A more challenging task is a restoration of facial symmetry during a onestep resection of lesions in the craniofacial region, following a skull reconstruction, where contour and shape may be difficult to achieve with intraoperative modeling of autogenous bone grafts, titanium, or another synthetic material (4).…”

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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Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

Yashin,

Zinatullin,

Bratsev

et al. 2024

Nejrohirurgiâ (Mosk.)

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Background. In patients with skull bone tumors, it was demonstrated that not only the oncological but also the cosmetic result has a significant influence on the long-term outcome. The traditional approach to the surgical treatment of tumor lesions of the skull bones is removal of the tumor and intraoperative modeling an artificial bone flap without a template. Recently, the technology of simultaneous resection and computer-aided design/computer-aided manufacturing (CAD/CAM) cranioplasty has received more and more attention.Aim. To compare the results of surgical treatment of patients with tumors of the cranial bones using the traditional approach (intraoperative formation of a plate to close the defect) and simultaneous resection followed by plastic surgery of the defect with a personalized implant made using preoperative virtual modeling.Materials and methods. The study included 24 patients with tumors of the skull or meningiomas with extracranial growth. Depending on the surgical procedure, patients were divided into 2 groups: group 1 (n = 13) – the technology of simultaneous resection and CAD/CAM cranioplasty; group 2 (n = 11) – where surgery was performed using a traditional approach based on intraoperative modeling an artificial bone flap without a template.Results. There were no statistically significant differences between groups in gender, age, time of surgery, blood loss, or time in hospital. The use of simultaneous resection and CAD/CAM cranioplasty did not demonstrate a statistically significant better result in terms of maintaining skull symmetry compared to the traditional approach. All patients had a good cosmetic result and there were no complications.Conclusion. The technology of simultaneous resection and CAD/CAM cranioplasty is an effective method of treating patients with neoplasmas of the skull bones. Despite the absence of statistically significant differences in the results of treatment of cranial bone tumors between this method and the traditional approach based on intraoperative modeling an artificial bone flap without a template this method seems to be a more precise providing the best cosmetic effect in patients with lesion in fronto-orbital region.

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Fronto-naso-orbital Reconstructions

Cited by 4 publications

References 8 publications

Reconstruction for diverse fronto-orbital defects with computer-assisted designed and computer-assisted manufactured PEEK implants in one-stage operation

Reconstruction for diverse fronto-orbital defects with computer-assisted designed and computer-assisted manufactured PEEK implants in one-stage operation

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

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

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