Gerbino Giovanni, Bianchi Francesca Antonella, Zavattero Emanuele, Tartara Fulvio, Garbossa Diego, Ducati Alessandro
Assistant Professor, Division of Maxillofacial Surgery, Department of Head and Neck Surgery, San Giovanni Battista Hospital, University of Turin, Turin, Italy.
J Oral Maxillofac Surg. 2013 Nov;71(11):1969-82. doi: 10.1016/j.joms.2013.03.021. Epub 2013 May 13.
The aim of this study was to evaluate surgical outcomes using patient-specific prostheses produced by computer-aided design and manufacturing for primary reconstruction in patients with benign cranio-orbital tumors. Polyetheretherketone was used to manufacture the implants.
The present study included 3 patients who underwent fronto-orbito-pterional craniotomy using individual custom-made surgical guides. Patient-specific polyetheretherketone prostheses were used for reconstruction during the same surgery. All patients underwent esthetic examination (facial and orbital symmetry, globe projection and position), ophthalmologic examination (diplopia with the Hess-Lancaster test, visual field and acuity), and radiologic evaluations (computed tomography and magnetic resonance imaging) during the preoperative and follow-up periods. Operating time and short- and long-term complications were recorded.
The immediate and long-term morphologic results were satisfactory; in particular, ocular globe position and projection were correct. After 25 to 31 months, none of the patients developed implant-related complications, such as infection, extrusion, or malposition. Two-year postoperative computed tomograms and magnetic resonance images showed no recurrences.
Single-step resection and reconstruction with computer-aided designed and manufactured implants is a challenging new technique that decreases operative time and morbidity. The implants adequately restore an anatomically complex area with satisfactory cosmetic results.
本研究旨在评估使用计算机辅助设计与制造的定制假体对良性颅眶肿瘤患者进行初次重建手术的效果。采用聚醚醚酮制造植入物。
本研究纳入3例行额眶翼点开颅手术并使用个体化定制手术导板的患者。在同一手术中使用定制的聚醚醚酮假体进行重建。所有患者在术前及随访期间均接受美学检查（面部和眼眶对称性、眼球突出度和位置）、眼科检查（使用Hess-Lancaster试验检查复视、视野和视力）以及影像学评估（计算机断层扫描和磁共振成像）。记录手术时间以及短期和长期并发症。
即刻和长期形态学结果均令人满意；特别是眼球位置和突出度正确。术后25至31个月，无患者出现与植入物相关的并发症，如感染、移位或位置不当。术后两年的计算机断层扫描和磁共振图像显示无复发。
使用计算机辅助设计与制造的植入物进行单步切除和重建是一项具有挑战性的新技术，可减少手术时间和发病率。植入物能充分恢复解剖结构复杂的区域，美容效果令人满意。
