scholarly journals MNGI-19. SURGICAL RESECTION OF SPHENO-ORBITAL MENINGIOMAS AND ORBITAL RECONSTRUCTION USING PATIENT SPECIFIC CAD/CAM IMPLANTS

2018 ◽  
Vol 20 (suppl_6) ◽  
pp. vi152-vi153
Author(s):  
Boris Krischek ◽  
Lukas Goertz ◽  
Marco Timmer ◽  
Roland Goldbrunner ◽  
Pantelis Stavrinou
Keyword(s):  
Surgical Resection ◽  
Patient Specific ◽  
Orbital Reconstruction ◽  
Cad Cam

scholarly journals Single-Step Resection of Sphenoorbital Meningiomas and Orbital Reconstruction Using Customized CAD/CAM Implants

2019 ◽  
Vol 81 (02) ◽  
pp. 142-148
Author(s):  
Lukas Goertz ◽  
Pantelis Stavrinou ◽  
George Stranjalis ◽  
Marco Timmer ◽  
Roland Goldbrunner ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Tumor Resection ◽  
Single Step ◽  
Ct Scans ◽  
Patient Specific ◽  
Orbital Decompression ◽  
Bone Resection ◽  
Orbital Reconstruction ◽  
Orbital Wall ◽  
Cad Cam

Abstract Objective Computer-aided design and manufacturing (CAD/CAM) implants are fabricated based on volumetric analysis of computed tomography (CT) scans and are routinely used for the reconstruction of orbital fractures. We present three cases of patients with sphenoorbital meningiomas that underwent tumor resection, orbital decompression, and orbital reconstruction with patient specific porous titanium or acrylic implants in a single procedure. Methods The extent of bone resection of the sphenoorbital meningiomas was planned in a virtual three-dimensional (3D) environment using preoperative thin-layer CT data. The anatomy of the orbital wall in the resection area was reconstructed by superimposing the contralateral unaffected orbit and by using the information of the neighboring bony structures. The customized implants and a corresponding craniotomy template were designed in the desired size and shape by the manufacturer. Results All patients presented with a sphenoorbital meningioma and exophthalmos. After osteoclastic craniotomy with the drilling template, orbital decompression was performed. Implant fitting was tight in two cases and could be easily fixated with miniplates and screws. In the third patient, a reoperation was necessary for additional bone resection, as well as drilling and repositioning of the implant. The postoperative CT scans showed an accurate reconstruction of the orbital wall. After surgery, exophthalmos was substantially reduced and a satisfying cosmetic result could be finally achieved in all patients. Conclusions The concept of preoperative 3D virtual treatment planning and single-step orbital reconstruction with CAD/CAM implants after tumor resection involving the orbit is well feasible and can lead to good cosmetic results.

scholarly journals Granular Cell Tumor: A Technical Approach for Resection of a Rare Suprasellar Mass

2020 ◽  
Vol 1 (4) ◽  
Author(s):  
Alexander J Schupper ◽  
Frank J Yuk ◽  
Hongyan Zou ◽  
Sadhna Ahuja ◽  
Nadejda M Tsankova ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Granular Cell Tumor ◽  
Clinical Presentation ◽  
Granular Cell ◽  
Cell Tumor ◽  
Patient Specific ◽  
Surgical Approaches ◽  
Technical Approach ◽  
Multiple Strategies ◽  
Current State

Abstract BACKGROUND AND IMPORTANCE Granular cell tumors (GCTs) of the sellar and suprasellar regions are rare tumors that may be managed surgically by multiple strategies. The technical approaches for these tumors have rarely been described in the literature. CLINICAL PRESENTATION We introduce the case of a patient presenting with dizziness and headaches who was found to have a suprasellar and retrochiasmatic mass and eventually underwent surgical resection. We discuss the characteristics of this tumor, and the current state of the literature. Also included are details regarding the surgical approach utilized in this case, and a discussion of the various surgical approaches for this type of tumor. CONCLUSION There are several approaches for the surgical resection of suprasellar GCTs, and the approach utilized may depend on patient and/or surgeon considerations. Patient-specific considerations must be made to ensure maximal safe resection of these lesions.

scholarly journals P05.72 Single-step resection of spheno-orbital meningiomas and orbital reconstruction using customized CAD/CAM implants

2018 ◽  
Vol 20 (suppl_3) ◽  
pp. iii320-iii320
Author(s):  
B Krischek ◽  
L Goertz ◽  
M TImmer ◽  
R Goldbrunner ◽  
P Stavrinou
Keyword(s):  
Single Step ◽  
Orbital Reconstruction ◽  
Cad Cam

Biomechanical In Vitro Study on the Stability of Patient-Specific CAD/CAM Mandibular Reconstruction Plates: A Comparison Between Selective Laser Melted, Milled, and Hand-Bent Plates

2020 ◽  
pp. 194338752095268
Author(s):  
Robin Kasper ◽  
Karsten Winter ◽  
Sebastian Pietzka ◽  
Alexander Schramm ◽  
Frank Wilde
Keyword(s):  
In Vitro Study ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Plate Fracture ◽  
Computer Aided ◽  
Cad Cam ◽  
Number Of Cycles ◽  
Bent Plates ◽  
Cam Systems

Study Design: An experimental in vitro study. Objective: Plate fractures are a recurrent problem in alloplastic mandibular reconstruction. Hypothetically it can be assumed that computer-aided design (CAD)/computer-aided manufacturing (CAM) reconstruction plates have a higher stability than conventional hand-bent plates. The aim of the study was to compare additive and subtractive fabricated CAD/CAM mandibular reconstruction plates as well as conventional plates with regard to their biomechanical properties. Methods: In a chewing simulator, plates of 2 conventional locking plate systems and 2 CAD/CAM-fabricated plate systems were compared. The plates were loaded in a fatigue test. The maximum number of cycles until plate fracture and the plate stiffness were compared. Results: While all conventional plates fractured at a maximum load between 150 and 210 N (Newton) after a number of cycles between 40 000 and 643 000, none of the CAD/CAM plates broke despite a nearly doubled load of 330 N and 2 million cycles. Both CAD/CAM systems proved to be significantly superior to the hand-bent plates. There was no difference between the 2 CAD/CAM systems. Conclusions: Concerning the risk of plate fracture, patient-specific CAD/CAM reconstruction plates appear to have a significant advantage over conventional hand-bent plates in alloplastic mandibular reconstruction.

Surgical Resection of Solitary Bone Plasmacytoma of Atlas and Reconstruction with 3-Dimensional−Printed Titanium Patient-Specific Implant

2020 ◽  
Vol 139 ◽  
pp. 322-329
Author(s):  
Yuxi Li ◽  
Guan Zheng ◽  
Ting Liu ◽  
Yuwei Liang ◽  
Jiajun Huang ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Patient Specific ◽  
3 Dimensional ◽  
Solitary Bone Plasmacytoma

scholarly journals Computer-Assisted Mandibular Reconstruction using a Patient-Specific Reconstruction Plate Fabricated with Computer-Aided Design and Manufacturing Techniques

2014 ◽  
Vol 7 (2) ◽  
pp. 158-166 ◽  
Author(s):  
Frank Wilde ◽  
Carl-Peter Cornelius ◽  
Alexander Schramm
Keyword(s):  
Computer Aided Design ◽  
Mandibular Reconstruction ◽  
Patient Specific ◽  
Computer Assisted ◽  
Reconstruction Plate ◽  
Fibula Flap ◽  
Computer Aided ◽  
Cad Cam ◽  
Aided Design ◽  
Five Axis

We investigated the workflow of computer-assisted mandibular reconstruction that was performed with a patient-specific mandibular reconstruction plate fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) techniques and a fibula flap. We assessed the feasibility of this technique from virtual planning to the completion of surgery. Computed tomography (CT) scans of a cadaveric skull and fibula were obtained for the virtual simulation of mandibular resection and reconstruction using ProPlan CMF software (Materialise®/DePuy Synthes®). The virtual model of the reconstructed mandible provided the basis for the computer-aided design of a patient-specific reconstruction plate that was milled from titanium using a five-axis milling machine and CAM techniques. CAD/CAM techniques were used for producing resection guides for mandibular resection and cutting guides for harvesting a fibula flap. Mandibular reconstruction was simulated in a cadaveric wet laboratory. No problems were encountered during the procedure. The plate was fixed accurately to the residual bone without difficulty. The fibula segments were attached to the plate rapidly and reliably. The fusion of preoperative and postoperative CT datasets demonstrated high reconstruction precision. Computer-assisted mandibular reconstruction with CAD/CAM-fabricated patient-specific reconstruction plates appears to be a promising approach for mandibular reconstruction. Clinical trials are required to determine whether these promising results can be translated into successful practice and what further developments are needed.

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