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

Abstract

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.