Division of Neurosurgery, Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari "Aldo Moro", University Hospital Policlinico of Bari, Bari, Italy.
Acta Neurochir (Wien). 2024 Nov 22;166(1):470. doi: 10.1007/s00701-024-06361-y.
Early reconstruction of the skull represents the gold standard after resection of bone infiltrating cranial tumors. Customized hydroxyapatite porous ceramics are an excellent option for covering skull bone defects. The authors illustrate the surgical technique and investigate the effectiveness of the "one-step" procedure in terms of aesthetic results and early degree of osteointegration.
A prospective study was conducted, including all patients operated on for skull bone infiltrating lesions at our center between January 2020 and June 2022. Stereolithography was the technique used for shaping the epoxy-resin model, suitable for both designing the craniotomy and manufacturing the custom-made hydroxyapatite prosthesis. Clinical outcome, results of early (6-week) and late (3-month) osteointegration evaluated on CT and MRI, and level of patient satisfaction measured by the FACE-Q questionnaire were reported.
Fourteen patients (13 adults and a 7-year-old boy) and a total of 15 implants were included. The average percentage of early osteointegration calculated at the edge of the prosthesis, was 72.2%, that increased to 82.6% after 3 months. Patient-reported outcomes indicated a high level of satisfaction across all patients.
"One-step" resection and reconstruction using customized hydroxyapatite porous implants for treatment of skull infiltrating tumors is a safe, simple and effective technique, in particular when the bone defect is large. Bone regeneration around and inside the prosthesis seems to start early after surgery.
颅骨浸润性骨肿瘤切除后，早期重建颅骨是金标准。定制的羟基磷灰石多孔陶瓷是覆盖颅骨骨缺损的绝佳选择。作者介绍了手术技术，并研究了“一步法”在美学效果和早期骨整合程度方面的有效性。
进行了一项前瞻性研究，纳入了 2020 年 1 月至 2022 年 6 月期间在我们中心接受颅骨浸润性病变手术的所有患者。立体光刻技术用于制作环氧树脂模型，该模型既适合开颅设计，也适合制造定制的羟基磷灰石假体。报告了临床结果、早期（6 周）和晚期（3 个月）骨整合的结果（通过 CT 和 MRI 评估），以及通过 FACE-Q 问卷测量的患者满意度水平。
共纳入 14 名患者（13 名成人和 1 名 7 岁男孩）和 15 个植入物。在假体边缘计算的早期骨整合平均百分比为 72.2%，3 个月后增加到 82.6%。所有患者的报告均表明满意度水平较高。
使用定制的羟基磷灰石多孔植入物进行“一步法”切除和重建治疗颅骨浸润性肿瘤是一种安全、简单、有效的技术，特别是当骨缺损较大时。术后假体周围和内部的骨再生似乎很早就开始了。
