title: Skull reconstruction after resection of bone tumors in a single surgical time by the association of the techniques of rapid prototyping and surgical navigation.
abstract: OBJECTIVE
  Presentation of a new cranioplasty technique employing a combination of two technologies: rapid prototyping and surgical navigation. This technique allows the reconstruction of the skull cap after the resection of a bone tumor in a single surgical time.
  
  
  METHODS
  The neurosurgeon plans the craniotomy previously on the EximiusMed software, compatible with the Eximius Surgical Navigator, both from the company Artis Tecnologia (Brazil). The navigator imports the planning and guides the surgeon during the craniotomy. The simulation of the bone fault allows the virtual reconstruction of the skull cap and the production of a personalized modelling mold using the Magics-Materialise (Belgium)-software. The mold and a replica of the bone fault are made by rapid prototyping by the company Artis Tecnologia (Brazil) and shipped under sterile conditions to the surgical center. The PMMA prosthesis is produced during the surgical act with the help of a hand press.
  
  
  RESULTS
  The total time necessary for the planning and production of the modelling mold is four days. The precision of the mold is submillimetric and accurately reproduces the virtual reconstruction of the prosthesis. The production of the prosthesis during surgery takes until twenty minutes depending on the type of PMMA used. The modelling mold avoids contraction and dissipates the heat generated by the material's exothermic reaction in the polymerization phase. The craniectomy is performed with precision over the drawing made with the help of the Eximius Surgical Navigator, according to the planned measurements. The replica of the bone fault serves to evaluate the adaptation of the prosthesis as a support for the perforations and the placement of screws and fixation plates, as per the surgeon's discretion.
  
  
  CONCLUSIONS
  This technique allows the adequate oncologic treatment associated with a satisfactory aesthetic result, with precision, in a single surgical time, reducing time and costs.
authors.affiliation: Artis Tecnologia, Brasília, DF, Brazil. anchieta9@gmail.com.|Master in Biomedical Engineering, UNB/DF, Brasília, Brazil. anchieta9@gmail.com.
authors.forename: M V M
authors.initials: MV
authors.lastname: Anchieta
authors.affiliation: Artis Tecnologia, Brasília, DF, Brazil.
authors.forename: F A
authors.initials: FA
authors.lastname: Salles
authors.affiliation: Artis Tecnologia, Brasília, DF, Brazil.
authors.forename: B D
authors.initials: BD
authors.lastname: Cassaro
authors.affiliation: Artis Tecnologia, Brasília, DF, Brazil.
authors.forename: M M
authors.initials: MM
authors.lastname: Quaresma
authors.affiliation: Resident in Neurosurgery of the School of Medicine, UNIFESP, São Paulo, Brazil.
authors.forename: B F O
authors.initials: BF
authors.lastname: Santos
mesh_terms: D003399:Craniotomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D061646:Operative Time; D066230:Patient-Specific Modeling; D019736:Prostheses and Implants; D011474:Prosthesis Design / Q000379:methods*; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery*; D012888:Skull Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D012984:Software; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: Cranioplasty; Craniotomy; Decompressive craniectomy; Rapid prototyping; Reconstruction; Surgical navigation