Department of Neurosurgery, Instituto de Neurologia de Curitiba, Curitiba, Paraná, Brazil.
Engineering Departament, BMR Medical, Campina Grande do Sul, Paraná, Brazil.
World Neurosurg. 2021 Jul;151:44-51. doi: 10.1016/j.wneu.2021.04.053. Epub 2021 Apr 22.
Single-stage surgical treatment of cranial intraosseous meningiomas includes complete tumor resection followed by aesthetic reconstruction. Tailored tumor resection with a computer-aided design/computer-aided manufacturing custom-made implant for the defect has been advocated in recent years to achieve a satisfactory cosmetic result with reduced operative time and fewer complications. However, several technical nuances related to the area of osseous removal may compromise cranioplasty.
We present 2 cases of intraosseous meningiomas (sphenoid wing and retromastoid) to illustrate a step-by-step approach, from preoperative planning to single-step surgery.
For each case, a customized frame template delimiting bone removal was designed using cranial sutures as anatomical landmarks for precise placement of the cranioplasty template over the area of interest.
Custom templates based in cranial sutures may benefit single-step frame-guided resection and reconstruction of intraosseous tumors with compelling results.
颅骨内骨膜脑膜瘤的单阶段手术治疗包括完整的肿瘤切除，然后进行美容重建。近年来，提倡采用计算机辅助设计/计算机辅助制造定制植入物进行定制化的肿瘤切除术，以减少手术时间和并发症，达到满意的美容效果。然而，与骨切除区域相关的几个技术细节可能会影响颅骨成形术。
我们介绍了 2 例颅骨内脑膜瘤（蝶骨翼和乳突后）的病例，以说明从术前规划到单步手术的逐步方法。
对于每个病例，使用颅骨缝线作为解剖学标志，设计了一个定制的框架模板来限定骨切除，以便在感兴趣区域上精确放置颅骨成形术模板。
基于颅骨缝线的定制模板可能有利于单步框架引导的切除和重建颅骨内肿瘤，效果令人信服。
