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DOI: 10.1055/s-0028-1096199
© Thieme Medical Publishers
Spheno-orbital Reconstruction after Meningioma Resection
Publication History
Publication Date:
29 October 2008 (online)
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ABSTRACT
This report details a technique for spheno-orbital reconstruction after meningioma resection. The approach uses a life-size skull model generated from a thin-slice craniomaxillofacial computed tomogram. On this skull model, the planned area of bone removal of the involved orbit and sphenoid is outlined on the normal side opposite the lesion. A three-dimensional implant is then generated by reversing the anticipated area of bone resection on the normal side to create a mirror-image implant. This technique resulted in minimal intraoperative implant contouring, decreased surgical time, and satisfactory functional and cosmetic outcome.
KEYWORDS
Computer model - custom cranial implant - “reversed implant” - spheno-orbital reconstruction
REFERENCES
- 1 Maroon J C, Kennerdell J S, Vidovich D V, Abla A, Sternau L. Recurrent spheno-orbital meningioma. J Neurosurg. 1994; 80 202-208
- 2 Shick U, Bleyen J, Bani A, Hassler W. Management of meningiomas en plaque of the sphenoid wing. J Neurosurg. 2006; 104 208-214
- 3 Shrivastava R K, Sen C, Constantino P D, Della Rocca R. Sphenoorbital meningiomas: surgical limitations and lessons learned in their long-term management. J Neurosurg. 2005; 103 491-497
- 4 Carrizo A, Basso A. Current surgical treatment for sphenoorbital meningiomas. Surg Neurol. 1998; 50 574-578
- 5 Brusati R, Biglioli F, Mortini P, Raffaini M, Goisis M. Reconstruction of the orbital walls in surgery of the skull base for benign neoplasms. Int J Oral Maxillofac Surg. 2000; 29 325-330
- 6 Kelly C P, Cohen A J, Yavuzer R, Jackson I T. Cranial bone grafting for orbital reconstruction: is it still the best?. J Craniofac Surg. 2005; 16 181-185
- 7 Leake D, Gunnlaugsson C, Urban J, Marentette L. Reconstruction after resection of sphenoid wing meningiomas. Arch Facial Plast Surg. 2005; 7 99-103
- 8 Evans B T, Neil-Dwyer G, Lang D. Reconstruction following extensive removal of meningioma from around the orbit. Br J Neurosurg. 1994; 8 147-155
- 9 Columella F, Testa C, Andreoli A. Radical resection and reconstruction in spheno-ethmoidal-orbital tumors. Report of 3 cases. J Neurosurg Sci. 1974; 18 198-205
- 10 Bikmaz K, Mrak R, Al-Mefty O. Management of bone-invasive, hyperostotic sphenoid wing meningiomas. J Neurosurg. 2007; 107 905-912
- 11 Katano H, Aihara N, Takeuchi Y, Nozaki M, Yamada K. Tailor-made orbitocranioplasty for a sphenorbital encephalocele presenting as pulsatile exophthalmos: case report. J Neurosurg. 2007; 106(2 suppl) 126-130
- 12 Metzger M C, Schön R, Schmelzeisen R. Preformed titanium meshes: a new standard?. Skull Base. 2007; 17 269-272
- 13 Ringel F, Cedzich C, Schramm J. Microsurgical technique and results of a series of 63 spheno-orbital meningiomas. Neurosurgery. 2007; 60(4 suppl 2) 214-222 discussion 221-222
- 14 Westendorff C, Kaminsky J, Ernemann U, Reinert S, Hoffman J. Image-guided sphenoid wing meningioma resection and simultaneous computer-assisted cranio-orbital reconstruction: technical case report. Neurosurgery. 2007; 60(2 suppl 1) ONSE173-174 discussion ONSE174
- 15 Eppley B L. Craniofacial reconstruction with computer-generated HTR patient-matched implants: use in primary bony tumor excision. J Craniofac Surg. 2002; 13 650-657
- 16 Biomet microfixation implant information sheet. Biomet Web site. Available at: http://www.biometmicrofixation.com Accessed May 1, 2008
- 17 Bou-Assaly W, Illner A, Mosier K M, Kalnin A, Pritz M B. Intra-osseous meningioma of the orbit: an unusual presentation. Eur Radiol. 2007; 17 2192-2194
Michael B PritzM.D. Ph.D.
Department of Neurological Surgery, Indiana University School of Medicine, 545 Barnhill Drive
Emerson 141, Indianapolis, IN 46202-5124
Email: mpritz@iupui.edu