Single-Step Resection of an Intraosseous Meningioma and Cranial Reconstruction: Technical Note

Publication date: December 2017
Source:World Neurosurgery, Volume 108
Author(s): Charlotte-Elise Broeckx, Thomas J.J. Maal, Rinaldo D. Vreeken, Ruud R.M. Bos, Mark ter Laan
ObjectiveSimultaneous tumor resection and cranial reconstruction can be a challenging task. Surgical navigation is an indispensable tool in making this single-step procedure possible. In this technical note, we describe a new technique for this procedure to ensure a precise resection and optimal fit of the implant in a patient with an intraosseous meningioma.MethodsWe generated a 3-dimensional (3D) model of the patient's skull based on a computed tomography scan and created a digital "resection line" object using 3D Studio Max 2016 software. Based on this object, the patient-specific implant was generated and printed with a 3D printer. Before surgery, the digital object was transferred to the neuronavigation system to enable a navigated resection of the lesion to ensure maximum precision. During surgery, the craniotomy was performed, and the custom-made implant was fitted in a single step.ResultsThe planned resection was achieved, and the implant could be fitted without need for further adjustments to the resection border.ConclusionsWe provide a simple technique to digitally define a planned resection site and create a custom-made implant using specialized software and 3D printing to enable single-step resection of a skull lesion and cranial reconstruction, thereby reducing surgical time and costs and ensuring a good cosmetic result.



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