title: Virtual Resection and Subsequent Design of a Patient-Specific Alloplastic Implant in the Preoperative Planning and Surgical Treatment of a Venous Malformation of the Zygoma.
abstract: The authors present here the case of a 63-year-old female who developed a venous malformation of the left zygoma. These lesions are typically managed with nonoperative treatment, until or unless overt complicating symptoms require more aggressive surgical intervention. Reconstruction of the zygoma represents a challenge for the operating surgeon, considering its complex three-dimensional anatomy. Traditionally, the surgeon would estimate the appropriate margins of resection intraoperatively, and then design a construct to fit the defect using autologous bone grafts, allografts, or one of the various available alloplastic materials; however, for this patient preoperative virtual surgical planning was used. Using reconstructed three-dimensional images from the patient's maxillofacial computed tomography scan, the margins of the excision were virtually defined and the lesion "excised" during a preoperative planning session based on the specifications of the reconstructive surgeon. This process then allowed the design and production of custom osteotomy guides, and a patient-specific polyetheretherketone (PEEK) implant to match the resulting defect. The authors believe this methodology allows for a more efficient and precise overall procedural experience and reconstructive result, and has innumerable potential applications in the surgical treatment of craniofacial abnormality.
authors.affiliation: *Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center †Children's Hospital, New Orleans, LA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lavie
authors.forename: Mark W
authors.initials: MW
authors.lastname: Stalder
authors.forename: Hugo
authors.initials: H
authors.lastname: St Hilaire
mesh_terms: D001577:Benzophenones; D018786:Bone Substitutes / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007659:Ketones / Q000627:therapeutic use; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D010347:Patient Care Planning; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011108:Polymers; D019651:Plastic Surgery Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014584:User-Computer Interface; D054079:Vascular Malformations / Q000601:surgery*; D015050:Zygoma / Q000002:abnormalities* / Q000601:surgery
chemical_list: D001577:Benzophenones; D018786:Bone Substitutes; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols