title: Craniofacial reconstruction using patient-specific implants polyether ether ketone with computer-assisted planning.
abstract: Reconstruction of bony craniofacial defects requires precise understanding of the anatomic relationships. The ideal reconstructive technique should be fast as well as economical, with minimal donor-site morbidity, and provide a lasting and aesthetically pleasing result. There are some circumstances in which a patient's own tissue is not sufficient to reconstruct defects. The development of sophisticated software has facilitated the manufacturing of patient-specific implants (PSIs). The aim of this study was to analyze the utility of polyether ether ketone (PEEK) PSIs for craniofacial reconstruction. We performed a retrospective chart review from July 2009 to July 2013 in patients who underwent craniofacial reconstruction using PEEK-PSIs using a virtual process based on computer-aided design and computer-aided manufacturing. A total of 6 patients were identified. The mean age was 46 years (16-68 y). Operative indications included cancer (n = 4), congenital deformities (n = 1), and infection (n = 1). The mean surgical time was 3.7 hours and the mean hospital stay was 1.5 days. The mean surface area of the defect was 93.4 ± 43.26 cm(2), the mean implant cost was $8493 ± $837.95, and the mean time required to manufacture the implants was 2 weeks. No major or minor complications were seen during the 4-year follow-up. We found PEEK implants to be useful in the reconstruction of complex calvarial defects, demonstrating a low complication rate, good outcomes, and high patient satisfaction in this small series of patients. Polyether ether ketone implants show promising potential and warrant further study to better establish the role of this technology in cranial reconstruction.
authors.affiliation: *Division of Plastic and Reconstructive Surgery, Department of Surgery, Montefiore Medical Center, Bronx †Division of Plastic and Reconstructive Surgery, Department of Surgery, Mount Sinai Beth Israel, New York, New York.
authors.forename: Oscar J
authors.initials: OJ
authors.lastname: Manrique
authors.forename: Frank
authors.initials: F
authors.lastname: Lalezarzadeh
authors.forename: Erez
authors.initials: E
authors.lastname: Dayan
authors.forename: Joseph
authors.initials: J
authors.lastname: Shin
authors.forename: Daniel
authors.initials: D
authors.lastname: Buchbinder
authors.forename: Mark
authors.initials: M
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001577:Benzophenones; D017076:Computer-Aided Design; D019465:Craniofacial Abnormalities / Q000601:surgery*; D004986:Ether; D005260:Female; D006801:Humans; D007659:Ketones; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011108:Polymers; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; D004986:Ether; C063834:polyetheretherketone; D011092:Polyethylene Glycols