Fondazione Policlinico Gemelli IRCCS, Rome, Italy.
Ospedale Civile di Pescara, Pescara, Italy.
Neurosurg Rev. 2019 Sep;42(3):769-775. doi: 10.1007/s10143-019-01104-5. Epub 2019 May 4.
Treatment of intraosseous meningiomas is a two-staged procedure including tumor resection and cranial reconstruction. Several are the potential pitfall of this kind of surgery such as the conspicuous dimensions usually reached by the tumor and the peculiar involvement of irregular and deep bony structures. For these reasons, a surgical accurate virtual planning and a careful removal followed by tailored reconstruction are mandatory to achieve satisfactory results. We analyzed six patients operated on for intraosseous meningiomas between September 2014 and June 2018. Resection strategy was planned beforehand and shared with the manufacturer who provided the PEEK cranioplasty used in the reconstructive phase. Between September 2014 and April 2018, six patients affected by intraosseous meningioma were operated on. Female/male ratio was 5:1 and mean age was 54 ± 10.8 years. Mean FU was 20.3 ± 16.4 months. Mean dimension was 73.9 ± 24.8 mm × 69.2 ± 16.2 mm. Mean surgical time was 5.1 ± 1.1 h. The resection of intraosseous meningiomas requires the earliest and finest reconstructive phase. Custom-made implants should be considered the gold-standard for cranioplasty, especially in large skull and in frontal or hairless areas of the skull. The described technique is simple, accurate, and effective in achieving good results in disease control as well as cosmetic and functional restoration.
治疗骨内脑膜瘤需要分两步进行，包括肿瘤切除和颅骨重建。这种手术存在几个潜在的陷阱，例如肿瘤通常达到的显著尺寸以及不规则和深在骨结构的特殊受累。出于这些原因，精确的手术虚拟规划以及仔细的切除后进行定制重建是实现满意效果的必要条件。我们分析了 2014 年 9 月至 2018 年 6 月期间接受骨内脑膜瘤手术的 6 名患者。术前制定了切除策略，并与制造商共享，制造商提供了用于重建阶段的 PEEK 颅骨修复体。2014 年 9 月至 2018 年 4 月，我们对 6 名骨内脑膜瘤患者进行了手术。男女比例为 5:1，平均年龄为 54±10.8 岁。平均随访时间为 20.3±16.4 个月。平均尺寸为 73.9±24.8mm×69.2±16.2mm。平均手术时间为 5.1±1.1 小时。骨内脑膜瘤的切除需要尽早进行精细的重建阶段。定制植入物应被视为颅骨修复的金标准，尤其是在大颅骨和颅骨的额部或无毛区域。所描述的技术简单、准确、有效，在控制疾病以及美容和功能恢复方面均能取得良好效果。
