title: Preformed titanium cranioplasty after resection of skull base meningiomas - a technical note.
abstract: BACKGROUND
  Meningiomas of the fronto-basal skull are difficult to manage as the treatment usually includes extensive resection of the lesion, consecutive reconstruction of the meninges and of the skull. Especially after removal of spheno-orbital and sphenoid-wing meningiomas, the cosmetic result is of utmost importance. In this technical note, we present our institutional approach in the treatment of skull base meningiomas, focussing on the reconstruction of the neurocranium with individually preformed titanium cranioplasty (CRANIOTOP(®), CL Instruments, Germany).
  
  
  METHODS
  Two female patients (40 years, 64 years) are presented. Both patients presented with skull base lesions suggestive of meningiomas. The preoperative thin-sliced CT scan was processed to generate a 3D-model of the skull. On it, the resection was mapped and following a simulated resection, the cranioplasty was manufactured. Intra-operatively, the titanium plate served as a template for the skull resection and was implanted after microsurgical tumour removal, consecutively. The cosmetic result was excellent. Immediate postoperative CT scan revealed accurate fitting and complete tumour removal. Control Magnetic Resonance Imaging (MRI) within 12 weeks was possible without any artifacts.
  
  
  CONCLUSIONS
  The comprehensive approach described indicates only one surgical procedure for tumour removal and for reconstruction of the skull. The titanium plate served as an exact template for complete resection of the osseous parts of the tumour. Cosmetic outcome was excellent and control MRI was possible post operatively.
  
  
  CONCLUSIONS
  CRANIOTOP(®) cranioplasty is a safe and practical tool for reconstruction of the skull after meningioma surgery.
authors: Department of Neurosurgery, University Hospital of Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany. Electronic address: Karl-michael.schebesch@ukr.de.
authors: Karl-Michael
authors: KM
authors: Schebesch
authors: Julius
authors: J
authors: Höhne
authors: Holger G
authors: HG
authors: Gassner
authors: Alexander
authors: A
authors: Brawanski
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000737:chemistry*; D017076:Computer-Aided Design; D004954:Esthetics; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008579:Meningioma / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D008953:Models, Anatomic; D009915:Orbit / Q000601:surgery; D010347:Patient Care Planning; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012886:Skull / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery*; D013100:Sphenoid Bone / Q000601:surgery; D013701:Temporal Bone / Q000601:surgery; D014025:Titanium / Q000737:chemistry*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014584:User-Computer Interface
chemical_list: D001672:Biocompatible Materials; D014025:Titanium
keywords: CRANIOTOP; Skull base meningiomas; Sphenoid wing; Titanium cranioplasty