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Abstract：
BACKGROUND: Cranioplasty is a common procedure in neurosurgery. However, cosmetic and neuroprotective reconstructions are necessary after cranioplasty. Treatment of patients with a meningioma with bone infiltration requires removal of the tumor-infiltrated bone and subsequent cranioplasty. We report an efficient technique for cosmetic and neuroprotective reconstructions using a custom-made ultra-high-molecular-weight polyethylene cranial plate (SKULPIO, Kyocera Medical, Kyoto, Japan) in a single-step surgery involving tumor removal and skull reconstruction.
METHODS: We present 2 illustrative cases of a 49-year-old female with a right frontal convexity meningioma and 69-year-old male with a bilateral parasagittal atypical meningioma, both involving extensive skull invasion. We preoperatively planned craniotomy size to facilitate the removal of the tumor-infiltrated skull bone using the patients\' 3-dimensional cranial models followed by the construction of a custom-made cranial plate. After tumor removal, we drilled out the outer table and the diploe of the cranial edge until the custom-made bone plate accurately fit the bone defect. Finally, the cranial plate was fixed using titanium plates and screws.
RESULTS: Postoperative magnetic resonance imaging for each case revealed total meningioma removal and an aesthetically reconstructed skull. Using this technique, precise adjustment of the cranial edge to the plate contributes to a gapless and aesthetic reconstruction. Furthermore, the intact inner table of the skull firmly supports the custom-made bone plate.
CONCLUSIONS: This technique involving the placement of a custom-made cranial plate during a single-step surgery was found to be efficient for cosmetic and neuroprotective reconstructions.
METHODS: We present 2 illustrative cases of a 49-year-old female with a right frontal convexity meningioma and 69-year-old male with a bilateral parasagittal atypical meningioma, both involving extensive skull invasion. We preoperatively planned craniotomy size to facilitate the removal of the tumor-infiltrated skull bone using the patients\' 3-dimensional cranial models followed by the construction of a custom-made cranial plate. After tumor removal, we drilled out the outer table and the diploe of the cranial edge until the custom-made bone plate accurately fit the bone defect. Finally, the cranial plate was fixed using titanium plates and screws.
RESULTS: Postoperative magnetic resonance imaging for each case revealed total meningioma removal and an aesthetically reconstructed skull. Using this technique, precise adjustment of the cranial edge to the plate contributes to a gapless and aesthetic reconstruction. Furthermore, the intact inner table of the skull firmly supports the custom-made bone plate.
CONCLUSIONS: This technique involving the placement of a custom-made cranial plate during a single-step surgery was found to be efficient for cosmetic and neuroprotective reconstructions.
摘要：
背景：颅骨成形术是神经外科中常见的手术。然而,颅骨成形术后需要进行美容和神经保护性重建。患有骨浸润的脑膜瘤患者的治疗需要去除肿瘤浸润的骨并随后进行颅骨成形术。我们报告了一种使用定制的超高分子量聚乙烯颅板（SKULPIO，京瓷医疗,京都,日本）在涉及肿瘤切除和颅骨重建的单步手术中。
方法：我们提供了2例说明性病例，其中49岁女性患有右额凸面脑膜瘤，69岁男性患有双侧矢状旁非典型脑膜瘤，两者都涉及广泛的头骨入侵。我们术前计划开颅手术的大小，以方便使用患者的三维颅骨模型去除肿瘤浸润的颅骨，然后构建定制的颅骨板。肿瘤切除后,我们钻出了外台和颅骨边缘的双孔，直到定制的骨板准确地适合骨缺损。最后,颅板用钛板和螺钉固定。
结果：每个病例的术后磁共振成像显示脑膜瘤完全切除和美学上重建的颅骨。使用这种技术，颅骨边缘的精确调整板有助于无间隙和美学重建。此外，完整的头骨内表牢固地支撑着定制的骨板。
结论：这项涉及在单步手术中放置定制颅板的技术被发现对于美容和神经保护性重建是有效的。
方法：我们提供了2例说明性病例，其中49岁女性患有右额凸面脑膜瘤，69岁男性患有双侧矢状旁非典型脑膜瘤，两者都涉及广泛的头骨入侵。我们术前计划开颅手术的大小，以方便使用患者的三维颅骨模型去除肿瘤浸润的颅骨，然后构建定制的颅骨板。肿瘤切除后,我们钻出了外台和颅骨边缘的双孔，直到定制的骨板准确地适合骨缺损。最后,颅板用钛板和螺钉固定。
结果：每个病例的术后磁共振成像显示脑膜瘤完全切除和美学上重建的颅骨。使用这种技术，颅骨边缘的精确调整板有助于无间隙和美学重建。此外，完整的头骨内表牢固地支撑着定制的骨板。
结论：这项涉及在单步手术中放置定制颅板的技术被发现对于美容和神经保护性重建是有效的。
