To the content
3 . 2022

Application of patient-specific implants in the extensive space-occupying masses surgery of craniofacial zone

Abstract

Background. Removal of extensive volumetric neoplasms of the craniofacial zone is accompanied by the formation of large cranial bone defects, which require one-stage reconstruction to achieve optimal aesthetic and functional outcomes and preserve the patient’s quality of life. The stage of reconstruction should be as quick and minimally traumatic as possible. The possibility to refuse donor tissues allows to reduce the volume of surgical intervention, and the use of modern materials, computer modeling and three-dimensional printing technologies allow to create implants that match the anatomical features of a particular patient best of all.

Аim – to analyze the use of patient-specific implants for one-stage reconstruction of complex skull defects after removal of craniofacial zone space-occupying masses.

Material and methods. Eight patients with space-occupying masses in the craniofacial zone, after removal of which one-stage reconstruction of extensive bone defects was performed with patient-specific implants made of titanium or polyetheretherketone based on stereolithographic models or using three-dimensional printing, were included in the study from 2013 to 2021.

Results. In all observations the use of the patient-specific implants allowed to achieve the optimal cosmetic and functional results and to reduce the operation time as a result of the elimination of the implant intraoperative modeling stage.

Conclusion. Modern technologies of computer modeling and three-dimensional printing allow to produce patient-specific implants from a wide range of allomaterials. However, implants made of allomaterials still do not allow prosthetics to perform complex functions, as well as they are not capable of augmentation in growing children, do not exclude risks of infection and autoimmune reactions. The creation of alternative strategies for manufacturing patient-specific implants using the inventions of regenerative medicine, which combines the principles of cell and molecular biology, bioengineering, and tissue engineering, is advantageous.

Keywords:craniofacial reconstruction; patient-specific implants; surgery of craniofacial tumors

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Vasiliev S.A., Levin R.S., Aslanukov M.N., Oshchepkov S.K. Application of patient-specific implants in the extensive space-occupying masses surgery of craniofacial zone. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (3): 83–8. DOI: https://doi.org/10.33029/2308-1198-2022-10-3-83-88  (in Russian)

References

1.     Dean D., Min K., Bond A. Computer aided design of large-format prefabricated cranial plates. J Craniofac Surg. 2003; 14 (6): 819–32. DOI: https://doi.org/10.1097/00001665-200311000-00002  

2.     Scolozzi P. Maxillofacial reconstruction using polyetheretherketone patient-specific implants by «mirroring» computational planning. Aesthetic Plast Surg. 2012; 36 (3): 660–5. DOI: https://doi.org/10.1007/s00266-011-9853-2  

3.     Lai J., Sittitavornwong S., Waite P. Computer-assisted designed and computer-assisted manufactured polyetheretherketone prosthesis for complex fronto-orbito-temporal defect. J Oral Maxillofac Surg. 2011; 69 (4): 1175–80. DOI: https://doi.org/10.1016/j.joms.2010.05.034  

4.     Sakamoto Y., Koike N., Takei H., Ohno M., Shigematsu N., Kishi K. Influence of backscatter radiation on cranial bone fixation devices. J Craniofac Surg. 2018; 29 (4): 1094–6. DOI: https://doi.org/10.1097/scs.0000000000004392  

5.     Jalbert F., Boetto S., Nadon F., Lauwers F., Schmidt E., Lopez R. One-step primary reconstruction for complex craniofacial resection with PEEK custom-made implants. J Craniomaxillofac. Surg. 2014; 42 (2): 141–8. DOI: https://doi.org/10.1016/j.jcms.2013.04.001  

6.     Rudman K., Hoekzema C., Rhee J. Computer-assisted innovations in craniofacial surgery. Facial Plast. Surg. 2011; 27 (4): 358–65. DOI: https://doi.org/10.1055/s-0031-1283054  

7.     Hanasono M., Goel N., DeMonte F. Calvarial reconstruction with polyetheretherketone implants. Ann Plast Surg. 2009; 62 (6): 653–5. DOI: https://doi.org/10.1097/sap.0b013e318184abc7  

8.     Liao C., Li Y., Tjong S. Polyetheretherketone and its composites for bone replacement and regeneration. Polymers (Basel). 2020; 12 (12): 2858. DOI: https://doi.org/10.3390/polym12122858  

9.     Roskies M., Jordan J., Fang D., et al. Improving PEEK bioactivity for craniofacial reconstruction using a 3D printed scaffold embedded with mesenchymal stem cells. J Biomater Appl. 2016; 31 (1): 132–9. DOI: https://doi.org/10.1177/0885328216638636  

10. Borrelli M., Hu M., Longaker M., Lorenz H. Tissue engineering and regenerative medicine in craniofacial reconstruction and facial aesthetics. J Craniofac Surg. 2020; 31 (1): 15–27. DOI: https://doi.org/10.1097/scs.0000000000005840

CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)
Вскрытие
Medicine today

Уважаемые коллеги, до XI-го Национального конгресса с международным участием имени Н.О. Миланова "Пластическая хирургия, эстетическая медицина и косметология" осталось 3 дня! С 29 ноября по 1 декабря 2022 года в Москве пройдет XI Национальный конгресс "Пластическая хирургия,...

6-7 декабря 2022 года состоится юбилейная X конференция с международным участием "Креативная кардиология и кардиохирургия. Новые технологии диагностики и лечения заболеваний сердца", которая будет проходить в очном и онлайн-формате в ФГБУ "НМИЦ ССХ им. А.Н. Бакулева"...

Приглашаем 1 и 2 декабря в Москву на яркий профессиональный праздник - итоговую всероссийскую Школу РОАГ! Школа в Москве занимает особое место в образовательном цикле Школ РОАГ. На ней подводятся итоги прошедшего сезона, обсуждаются темы, которые вызывают наибольший интерес...


Journals of «GEOTAR-Media»