scholarly journals Intraosseous Venous Malformation of the Zygomatic Bone: Comparison between Virtual Surgical Planning and Standard Surgery with Review of the Literature

2021 ◽  
Vol 10 (19) ◽  
pp. 4565
Author(s):  
Raúl Antúnez-Conde ◽  
Carlos Navarro Cuéllar ◽  
José Ignacio Salmerón Escobar ◽  
Alberto Díez-Montiel ◽  
Ignacio Navarro Cuéllar ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Venous Malformation ◽  
Operation Time ◽  
Patient Specific ◽  
Primary Reconstruction ◽  
Zygomatic Bone ◽  
Virtual Surgical Planning ◽  
Patient Specific Implants ◽  
Cutting Guides ◽  
The Aesthetic

Intraosseous venous malformations affecting the zygomatic bone are infrequent. Primary reconstruction is usually accomplished with calvarial grafts, although the use of virtual surgical planning, cutting guides and patient-specific implants (PSI) have had a major development in recent years. A retrospective study was designed and implemented in patients diagnosed with intraosseous venous malformation during 2006–2021, and a review of the scientific literature was also performed to clarify diagnostic terms. Eight patients were treated, differentiating two groups according to the technique: four patients were treated through standard surgery with resection and primary reconstruction of the defect with calvarial graft, and four patients underwent resection and primary reconstruction through virtual surgical planning (VSP), cutting guides, STL models developed with CAD-CAM technology and PSI (titanium or Polyether-ether-ketone). In the group treated with standard surgery, 75% of the patients developed sequelae or morbidity associated with this technique. The operation time ranged from 175 min to 210 min (average 188.7 min), the length of hospital ranged from 4 days to 6 days (average 4.75 days) and the postoperative CT scan showed a defect surface coverage of 79.75%. The aesthetic results were “excellent” in 25% of the patients, “good” in 50% and “poor” in 25%. In the VSP group, 25% presented sequelae associated with surgical treatment. The operation time ranged from 99 min to 143 min (average 121 min), the length of hospital stay ranged from 1 to 2 days (average of 1.75 days) and 75% of the patients reported “excellent” results. Postoperative CT scan showed 100% coverage of the defect surface in the VSP group. The multi-stage implementation of virtual surgical planning with cutting guides, STL models and patient-specific implants increases the reconstructive accuracy in the treatment of patients diagnosed with intraosseous venous malformation of the zygomatic bone, reducing sequelae, operation time and average hospital stay, providing a better cover of the defect, and improving the precision of the reconstruction and the aesthetic results compared to standard technique.

scholarly journals Imaging, Virtual Planning, Design, and Production of Patient-Specific Implants and Clinical Validation in Craniomaxillofacial Surgery

2012 ◽  
Vol 5 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Per Dérand ◽  
Lars-Erik Rännar ◽  
Jan-M Hirsch
Keyword(s):  
Additive Manufacturing ◽  
Treatment Plan ◽  
Maxillofacial Surgery ◽  
Bone Substitutes ◽  
Patient Specific ◽  
Virtual Design ◽  
Patient Specific Implants ◽  
Cutting Guide ◽  
Ablative Surgery ◽  
Cutting Guides

The purpose of this article was to describe the workflow from imaging, via virtual design, to manufacturing of patient-specific titanium reconstruction plates, cutting guide and mesh, and its utility in connection with surgical treatment of acquired bone defects in the mandible using additive manufacturing by electron beam melting (EBM). Based on computed tomography scans, polygon skulls were created. Following that virtual treatment plans entailing free microvascular transfer of fibula flaps using patient-specific reconstruction plates, mesh, and cutting guides were designed. The design was based on the specification of a Compact UniLOCK 2.4 Large (Synthes®, Switzerland). The obtained polygon plates were bent virtually round the reconstructed mandibles. Next, the resections of the mandibles were planned virtually. A cutting guide was outlined to facilitate resection, as well as plates and titanium mesh for insertion of bone or bone substitutes. Polygon plates and meshes were converted to stereolithography format and used in the software Magics for preparation of input files for the successive step, additive manufacturing. EBM was used to manufacture the customized implants in a biocompatible titanium grade, Ti6Al4V ELI. The implants and the cutting guide were cleaned and sterilized, then transferred to the operating theater, and applied during surgery. Commercially available software programs are sufficient in order to virtually plan for production of patient-specific implants. Furthermore, EBM-produced implants are fully usable under clinical conditions in reconstruction of acquired defects in the mandible. A good compliance between the treatment plan and the fit was demonstrated during operation. Within the constraints of this article, the authors describe a workflow for production of patient-specific implants, using EBM manufacturing. Titanium cutting guides, reconstruction plates for fixation of microvascular transfer of osteomyocutaneous bone grafts, and mesh to replace resected bone that can function as a carrier for bone or bone substitutes were designed and tested during reconstructive maxillofacial surgery. A clinically fit, well within the requirements for what is needed and obtained using traditional free hand bending of commercially available devices, or even higher precision, was demonstrated in ablative surgery in four patients.

scholarly journals Applications of 3D Planning, Plastic Materials and Additive Manufacturing in Functional Rehabilitations in the Head and Neck Surgery

2018 ◽  
Vol 55 (3) ◽  
pp. 431-433
Author(s):  
Gheorghe Muhlfay ◽  
Zoltan Fabian ◽  
Radu Neagoe ◽  
Karin Ursula Horvath
Keyword(s):  
Additive Manufacturing ◽  
Surgical Planning ◽  
Standard Of Care ◽  
Neck Surgery ◽  
Patient Specific ◽  
Patient Specific Implants ◽  
Planning Software ◽  
Plastic Materials ◽  
Potential Benefits ◽  
Manufacturing Technologies

The developments in the biocompatible materials and additive manufacturing technologies gave birth to new possibilities in reconstructive surgery. In addition to revolutionizing the diagnostic possibilities, the modern medical imaging has led to the development of surgical planning software. Using these state-of-the-art technologies, a new standard of care is rising with the spread of patient specific implants. Our view in studying and using these materials and technologies goes beyond their biocompatibility, focusing on the functional and esthetic impact of these restorations. Our aim is to show their potential benefits and pitfalls presenting a couple of posttraumatic and oncological application possibilities, focusing on the new presurgical planning, choice of materials and manufacturing technologies.

Virtual Surgical Planning: Patient-Specific Imaging Segmentation

2019 ◽  
pp. 743-746
Author(s):  
F. W. Grillo ◽  
C. Rondinoni ◽  
A. C. S. S. Filho ◽  
F. H. Simozo ◽  
J. A. Farina ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Patient Specific ◽  
Virtual Surgical Planning
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