Hobert Marc, Sharma Neha, Benzimra Caroline, Hinden Sandro, Oevermann Anna, Maintz Michaela, Beyer Michel, Thieringer Florian, Guevar Julien
AniCura Tierklinik Thun, Thun, Switzerland.
Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
Front Vet Sci. 2024 Aug 29;11:1459272. doi: 10.3389/fvets.2024.1459272. eCollection 2024.
To report a digital workflow for use and long-term outcome of cranioplasty with a 3D-printed patient-specific Polyetheretherketone (PEEK) implant in a 12-y-old German Shepherd dog after surgical removal of an extensive occipital bone multilobular osteochondrosarcoma (MLO).
Retrospective case report.
A 12-year-old neutered female German Shepherd dog was presented with facial deformity, blindness, tetraparesis, and ataxia. Magnetic resonance imaging (MRI) and computed tomography (CT) identified a large skull-based mass extending extra-and intracranially with severe compression of the cerebellum and occipital lobes of the cerebrum.
One-stage decompressive craniectomy using virtual surgical planned 3D-printed craniotomy cutting guides and the Misonix BoneScalpel and reconstruction with a patient-specific 3D-printed PEEK cranial implant.
3D-printed craniectomy cutting guides allowed an adequate fit of the cranial implant to the original skull. Misonix BoneScalpel allowed performing a safe and extensive craniectomy. Postoperative CT (8 weeks after surgery) confirmed the PEEK cranial implant to be in place and without implant rejection. Clinically, the neurological examination identified only a right-hind limb delay in proprioception 8 weeks postoperatively, which remained unchanged at 18 months after surgery. Adjunctive treatment included metronomic chemotherapy. Eighteen months after surgery the dog passed away for reasons unrelated to the MLO, no implant-related complications were reported.
3D-printed craniectomy cutting guides, patient-specific PEEK cranial implant, and metronomic chemotherapy can lead to a successful long-term outcome in dogs with extensive skull MLO.
PEEK is an alternative biomaterial that can be used successfully for skull reconstruction.
报告一只12岁德国牧羊犬在手术切除广泛的枕骨多叶性骨肉瘤（MLO）后，使用3D打印的患者特异性聚醚醚酮（PEEK）植入物进行颅骨成形术的数字化工作流程及长期结果。
回顾性病例报告。
一只12岁绝育雌性德国牧羊犬，出现面部畸形、失明、四肢轻瘫和共济失调。磁共振成像（MRI）和计算机断层扫描（CT）显示一个大的颅底肿物，向颅外和颅内延伸，严重压迫小脑和大脑枕叶。
使用虚拟手术规划的3D打印开颅切割导板和Misonix骨刀进行一期减压颅骨切除术，并用患者特异性3D打印PEEK颅骨植入物进行重建。
3D打印的颅骨切除切割导板使颅骨植入物与原始颅骨充分贴合。Misonix骨刀使安全、广泛的颅骨切除得以进行。术后CT（术后8周）证实PEEK颅骨植入物在位，无植入物排斥反应。临床上，神经学检查仅发现术后8周右后肢本体感觉延迟，术后18个月仍未改变。辅助治疗包括节拍化疗师。术后18个月，该犬因与MLO无关的原因死亡，未报告与植入物相关的并发症。
3D打印的颅骨切除切割导板、患者特异性PEEK颅骨植入物和节拍化疗可使患有广泛颅骨MLO的犬获得成功的长期结果。
PEEK是一种可成功用于颅骨重建的替代生物材料。
