Usefulness of an Osteotomy Template for Skull Tumorectomy and Simultaneous Skull Reconstruction

Oji, Tomito; Sakamoto, Yoshiaki; Miwa, Takaki; Nakagawa, Yu; Yoshida, Kazunari; Kishi, Kazuo

doi:10.1097/scs.0000000000002841

Cited by 8 publications

(11 citation statements)

References 15 publications

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“…A prefabricated reconstruction plate in fact, allows pre-drilling the holes in the native mandible prior to the osteotomy to allow for a precise placement of the fibular graft. In craniofacial surgery, 3D printed models have been used to assist pre-operative flap design in the treatment of Parry-Romberg syndrome [15] as well as in the design of osteotomy templates for skull tumorectomy [16].…”

Section: Background and Aims Of The Workmentioning

confidence: 99%

“…The pediatric craniofacial population provides distinct challenges in the design of custom made implants mainly due to congenital deformities with varying degrees of bilateral dysmorphism [21,22], thus precluding the ability to plan reconstructions based on the healthy hemi-face [23]. Moreover, the defect can be caused by a trauma [24] or a tumor's resection [16] that requires a sequence of surgical procedures. Finally, surgical correction must allow for, and anticipate, further growth and development, often with the knowledge that dysmorphic relapse may occur [25].…”

Section: Background and Aims Of The Workmentioning

confidence: 99%

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Surgery of complex craniofacial defects: A single-step AM-based methodology

Volpe

Furferi

Governi

et al. 2018

Computer Methods and Programs in Biomedicine

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Background and objectiveThe purpose of the present paper is to pave the road to the systematic optimization of complex craniofacial surgical intervention and to validate a design methodology for the virtual surgery and the fabrication of cranium vault custom plates. Recent advances in the field of medical imaging, image processing and additive manufacturing (AM) have led to new insights in several medical applications. The engineered combination of medical actions and 3D processing steps, foster the optimization of the intervention in terms of operative time and number of sessions needed. Complex craniofacial surgical intervention, such as for instance severe hypertelorism accompanied by skull holes, traditionally requires a first surgery to correctly "resize" the patient cranium and a second surgical session to implant a customized 3D printed prosthesis. Between the two surgical interventions, medical imaging needs to be carried out to aid the design the skull plate. Instead, this paper proposes a CAD/AM-based one-in-all design methodology allowing the surgeons to perform, in a single surgical intervention, both skull correction and implantation. MethodsA strategy envisaging a virtual/mock surgery on a CAD/AM model of the patient cranium so as to plan the surgery and to design the final shape of the cranium plaque is proposed. The procedure relies on patient imaging, 3D geometry reconstruction of the defective skull, virtual planning and mock surgery to determine the hypothetical anatomic 3D model and, finally, to skull plate design and 3D printing. ResultsThe methodology has been tested on a complex case study. Results demonstrate the feasibility of the proposed approach and a consistent reduction of time and overall cost of the surgery, not to mention the huge benefits on the patient that is subjected to a single surgical operation. ConclusionsDespite a number of AM-based methodologies have been proposed for designing cranial implants or to correct orbital hypertelorism, to the best of the authors' knowledge, the present work is the first to simultaneously treat osteotomy and titanium cranium plaque.

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Section: Background and Aims Of The Workmentioning

confidence: 99%

Section: Background and Aims Of The Workmentioning

confidence: 99%

Surgery of complex craniofacial defects: A single-step AM-based methodology

Volpe

Furferi

Governi

et al. 2018

Computer Methods and Programs in Biomedicine

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“…This technique facilitates the recognition of real tumor margins and allows surgeons to overcome technical errors in treating complex bone structures. It has also been demonstrated to eliminate the need for implant trimming for cranioplasty, allowing the operator to determine the exact edge of skull tumors (24,36). Hence, the skull can be reconstructed with a 3D-printed titanium plate immediately, and the operation time can be reduced (15).…”

Section: Discussionmentioning

confidence: 99%

Cranioplasty for Multilobular Osteochondrosarcoma Using 3-Dimensional Printing Technology in Dogs: A Report of Two Cases with a Long-Term Follow-Up

et al. 2022

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Multilobular osteochondrosarcoma (MLO) reportedly has a good prognosis after complete resection. This study reports the successful treatment of MLO in two dogs using 3-dimensional (3D) printing technology. A nine-yearold castrated male Maltese (Case 1) and a five-year-old castrated male poodle (Case 2) both presented with a mass in the skull. Diagnostic imaging revealed a cranial mass arising from the cranio-orbital and parieto-occipital bones. The masses were resected using 3D-printed osteotomy guides, and the resulting defects were reconstructed using 3D-printed patient-specific implants. Histopathological results confirmed the resection of MLOs with clean margins. Patients routinely recover from surgery without complications. To date, the two patients remain alive without clinical signs of tumor recurrence at 20 and 12 months postoperatively, respectively. In the management of MLO in dogs, 3D printing technology can allow accurate tumor resection, reduced surgical time, and successful reconstruction of large defects.

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“…This is an invited discussion of an article by Oji et al entitled “Usefulness of an osteotomy template for skull tumourectomy and simultaneous skull reconstruction” that is published in the journal (1). In summary, their consecutive case series of three patients receiving “custom implant cranioplasty” following standard benign skull neoplasm tumor resection describes a retrospective analysis of non-randomized, non-controlled outcomes for patients receiving single-stage reconstruction with pre-fabricated, patient-specific implants and cutting guide templates.…”

mentioning

confidence: 99%

“…Instead, we have decided to engage our university engineers to co-develop computer-assisted and robot-assisted technologies to possibly overcome these modern day hurdles. As such, we are not quite sure this approach by Jin et al - in relation to achieving ideal skull tumor resection by way of pre-designed, cutting guides - is ideal (1). For example, their group reports that “ perioperative trimming of the implant or bone defect was not required in any case, and good cosmetic outcomes were obtained in all cases, without any complications .” With two cases involving fibrous dysplasia and one meningioma, it will take significant time to see if and when local recurrence presents itself.…”

mentioning

confidence: 99%