title: One-step primary reconstruction for complex craniofacial resection with PEEK custom-made implants.
abstract: OBJECTIVE
  Reconstruction of large craniofacial defects has largely improved since custom-made implants have been developed in the past decade. For large lesions in fronto-orbital region (such as osteomeningioma), we applied a simple and reliable protocol to perform optimal primary reconstruction with PEEK (polyetheretherketone) specific implant at the same time of the resection.
  
  
  METHODS
  Our protocol is based on virtual preoperative surgery with a planned bone resection that allows engineering of a specific implant to accurately fit to the defect during the surgery. Thus tumour removal and optimal immediate reconstruction are performed easily in a single-step procedure. The use of navigation is required to perform accurate resection according to the planning. We report our experience in five patients requiring complex orbito-frontal reconstruction.
  
  
  RESULTS
  Planned resection was always achieved with accurate placement of the implant. Optimal orbital reconstruction is allowed and permits exophthalmos correction and orbital contour symmetry. No major complication was observed.
  
  
  CONCLUSIONS
  We provide a simple one-step technique to reconstruct the orbit while achieving symmetric cosmetic and functional results, reducing operative time and avoiding donor site morbidity.
authors.affiliation: Maxillofacial Department, CHU Purpan, Toulouse, France. Electronic address: jalbert.f@chu-toulouse.fr.
authors.forename: F
authors.initials: F
authors.lastname: Jalbert
authors.affiliation: Neurosurgery Department, CHU Purpan, Toulouse, France.
authors.forename: S
authors.initials: S
authors.lastname: Boetto
authors.affiliation: Maxillofacial Department, CHU Purpan, Toulouse, France.
authors.forename: F
authors.initials: F
authors.lastname: Nadon
authors.affiliation: Maxillofacial Department, CHU Purpan, Toulouse, France.
authors.forename: F
authors.initials: F
authors.lastname: Lauwers
authors.affiliation: Neurosurgery Department, CHU Purpan, Toulouse, France.
authors.forename: E
authors.initials: E
authors.lastname: Schmidt
authors.affiliation: Maxillofacial Department, CHU Purpan, Toulouse, France.
authors.forename: R
authors.initials: R
authors.lastname: Lopez
mesh_terms: D000328:Adult; D000368:Aged; D001577:Benzophenones; D001672:Biocompatible Materials / Q000737:chemistry; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000601:surgery*; D005626:Frontal Sinus / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007659:Ketones / Q000737:chemistry; D008297:Male; D008579:Meningioma / Q000601:surgery; D008875:Middle Aged; D009078:Mucocele / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009915:Orbit / Q000601:surgery*; D010254:Paranasal Sinus Diseases / Q000601:surgery; D010347:Patient Care Planning; D011092:Polyethylene Glycols / Q000737:chemistry; D011108:Polymers; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D012888:Skull Neoplasms / Q000601:surgery*; D013100:Sphenoid Bone / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods; D014584:User-Computer Interface
chemical_list: D001577:Benzophenones; D001672:Biocompatible Materials; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols
keywords: CAD/CAM; Computer-assisted surgery; Craniofacial reconstruction; Navigation; One-step surgery; Orbital reconstruction; PEEK