title: Neuronavigation-assisted cranial reconstruction.
abstract: OBJECTIVE
  Cranial defects resulting from congenital deformities, ablative resection of osseous tumors, traumatic injury, and destructive infectious lesions are often severe enough to warrant surgical reconstruction. In particular cases, satisfactory cosmetic results may be difficult to achieve because of the extent and location of the lesion.
  
  
  METHODS
  We evaluated the role of neuronavigation for reconstruction of large cranial defects with prefabricated titanium and intraoperatively constructed neuronavigation-assisted polymethylmethacrylate implants.
  
  
  RESULTS
  Neuronavigation-assisted cranial reconstruction was performed in 14 patients. Surgical procedure, illustrative cases, postoperative results, and apparent benefits of the technique are presented and discussed. In all patients, excellent cosmetic results were achieved.
  
  
  CONCLUSIONS
  In cranial reconstruction, neuronavigation is of value not only for intraoperative determination of resection margins but also for preoperative assessment and planning. The combination of navigation techniques with prefabricated or intraoperatively constructed implants enables achievement of excellent cosmetic results.
authors.affiliation: Department of Neurosurgery, Albert-Ludwigs University of Freiburg, Freiburg im Breisgau, Germany. vvougio@nz.ukl.uni-freiburg.de
authors.forename: Vassilios I
authors.initials: VI
authors.lastname: Vougioukas
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hubbe
authors.forename: Vera
authors.initials: V
authors.lastname: van Velthoven
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Freiman
authors.forename: Alexander
authors.initials: A
authors.lastname: Schramm
authors.forename: Uwe
authors.initials: U
authors.lastname: Spetzger
mesh_terms: D000328:Adult; D000368:Aged; D018786:Bone Substitutes / Q000627:therapeutic use; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D038361:Neuronavigation; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012886:Skull / Q000473:pathology* / Q000601:surgery*; D014025:Titanium / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes; D019904:Polymethyl Methacrylate; D014025:Titanium