Jalbert F, Boetto S, Nadon F, Lauwers F, Schmidt E, Lopez R
Maxillofacial Department, CHU Purpan, Toulouse, France.
Neurosurgery Department, CHU Purpan, Toulouse, France.
J Craniomaxillofac Surg. 2014 Mar;42(2):141-8. doi: 10.1016/j.jcms.2013.04.001. Epub 2013 May 18.
Reconstruction of large craniofacial defects has largely improved since custom-made implants have been developed in the past decade. For large lesions in fronto-orbital region (such as osteomeningioma), we applied a simple and reliable protocol to perform optimal primary reconstruction with PEEK (polyetheretherketone) specific implant at the same time of the resection.
Our protocol is based on virtual preoperative surgery with a planned bone resection that allows engineering of a specific implant to accurately fit to the defect during the surgery. Thus tumour removal and optimal immediate reconstruction are performed easily in a single-step procedure. The use of navigation is required to perform accurate resection according to the planning. We report our experience in five patients requiring complex orbito-frontal reconstruction.
Planned resection was always achieved with accurate placement of the implant. Optimal orbital reconstruction is allowed and permits exophthalmos correction and orbital contour symmetry. No major complication was observed.
We provide a simple one-step technique to reconstruct the orbit while achieving symmetric cosmetic and functional results, reducing operative time and avoiding donor site morbidity.
在过去十年中，随着定制植入物的研发，大型颅面缺损的重建有了很大改善。对于额眶区域的大型病变（如骨脑膜瘤），我们应用了一种简单可靠的方案，在切除病变的同时使用聚醚醚酮（PEEK）定制植入物进行最佳的一期重建。
我们的方案基于术前虚拟手术及计划好的骨切除，这使得在手术过程中能够设计出特定的植入物，精确适配缺损部位。这样，肿瘤切除和最佳即时重建可在一个单步骤过程中轻松完成。需要使用导航系统以根据计划进行精确切除。我们报告了对五例需要复杂眶额重建患者的治疗经验。
总能按计划完成切除，并准确植入植入物。实现了最佳的眼眶重建，可矫正眼球突出并使眼眶轮廓对称。未观察到重大并发症。
我们提供了一种简单的单步骤技术来重建眼眶，同时实现对称的美容和功能效果，减少手术时间并避免供区并发症。
