Utilization of an Acrylic 3‐D Model for Surgical Planning of a Skull Base Chondroblastoma

Abstract

Objective: Present a case of chondroblastoma of the temporal bone presenting as a facial nerve paralysis and explain the use of a 3-D acrylic model in surgical resection planning. Study Design: Case presentation. Methods: Benign chondroblastomas of the temporal bone are extremely rare. Approximately 1% of all chondroblastomas affect the skull base, with about 34 cases reported in the literature. Most patients are older (average age 43.8 years) and present with otologic symptoms such as tinnitus, hearing loss, otalgia, vertigo and ear fullness. Temporal bone chondroblastomas tend to be more aggressive requiring more extensive resection. We report the first case reported in the literature of chondroblastoma of the temporal bone presenting with facial nerve paralysis. A 3-D acrylic model of the temporal bone and skull base was used preoperatively to plan the surgical approach for resection and also reconstruction of the skull base defect. The tumor was subsequently completely excised via a Fisch Type B infratemporal fossa approach. Reconstruction was achieved using an iliac crest free flap. At one year postoperatively, the patient is free of disease with full facial nerve function. Results: Successful resection of chondroblastoma of the temporal bone and reconstruction with an iliac crest free flap with the aid of a 3-D acrylic model. Conclusions: Chondroblastomas of the temporal bone are extremely rare. Surgical resection and reconstruction can be challenging. 1) The use of 3-D models can be very beneficial when planning the surgical resection of temporal bone/skull base tumors. 2) Iliac crest free flap is a very suitable option to consider when planning post-resection reconstruction.