---

Case Study - The Effect of Malar Augmentation

In the case study below, both patient and surgeon reported a good satisfactory outcome directly post-operatively and at the six-month follow-up.

	The orange area is the mismatch when compared to the contralateral side. The surgeon marked in black the extent that he wanted to repair. The white contour is the final implant that was made.
	This is a colour-difference map showing the change in contour, i.e. an augmentation of 1mm to 3mm across the region of interest.

Back To Top

---

Case Study - Illustration of the Importance of a Customised Repair

These show the post-operative aspect of the patient's soft tissue following a non-customised repair (in this case, using standard mesh). The patient then needs a second operation to rectify this.

Cavendish Implants swift service provides the customised implant within 4 days. This is so that the surgeon can order the implant for primary surgery. The implant gives the patient a correct contour and is a permanent repair.

Back To Top

---

Case Study - Specific Implant

We present here a young female patient with neurofibroma who had previous eye and skull surgery. The eye socket needed to be reconstructed with a concave shape to allow an eye prosthesis to be fitted. Furthermore the temporalis area had been extensively eroded by the tumour. Due to the very likely regrowth of the tumour, surgeons wanted a strong impervious barrier to preserve the outer contours of the patient's skin and eye socket.

Back To Top

---

Case Study - The importance of orbital curvatures

The orbital floor and wall curvatures define the position of the orbit in terms of both functionality and aesthetics. The implant reconstructing these curvatures must therefore have the correct curvatures to provide a satisfactory repair. We present below what we see on a regular basis: a patient whose ineffective orbital repair needed revision with a customised implant to achieve the correct result.

	This CT scan reconstruction shows the shape of the primary repair: it is cylindrical as opposed to achieving the anterior-posterior S-shape raising and supporting the eye ball higher up in the orbit.
	It was a difficult task to remove the original repair (left). It was then replaced by the customised repair (right) which will 1) hold its shape while being inserted, 2) be inserted through a minimally invasive incision, and 3) achieve the correct contour to restore the correct anatomical position of the eye ball.
	The location of the incision to insert the customised implant is usually just above or just under the eye lash line. The implant is then securely attached to the orbital rim. Please note that the incision is usually smaller than shown on this photo (here necessary to gain access to and extract the original repair).

Back To Top

---

Case Study - Temporalis Suspension

The temporalis suspension feature has been on our cranioplasty implants since 2008.

Re-suspension of the temporalis muscle may be very effective at improving the cosmetic outcome for the patient. The pictures below illustrate how to make full use of the temporalis feature that is on all our titanium and PEEK cranioplasty implants wherever possible.

The first picture shows the principle of the design: our implants are drilled with a set of paired holes that the surgeon uses to lace the edge of the muscle back to its original position. The other pictures show the progression of this lacing process in theatre.

Back To Top

---

Case Study - "Two-in-One" operation with prefabricated implant

Bone tumours are a particular example of cases where it is often possible to perform two procedures in one: 1) the removal of the tumour, and 2) the insertion of our implant to restore the skull protection and contour. We consult with the surgeon to define the planned extent of the resection on the CT scan. The implant is then designed to extend onto the remaining bone for secure attachment. If there is any uncertainty in the likely extent of resection, one option is to err on the side of caution and make the plate extend further. If some bone is found to be healthy, it can remain as the plate will fit over the top of it.

This case presents a patient who was suffering from a frontal meningioma. The tumour resection and the implant design were planned with the surgeon with the view of providing the patient with a quicker completion of his treatment. The patient did not have to experience the discomfort of a cranial defect between procedures.

The photos below show the patient cranium at various stages of the procedure: prior to surgery, the CT scan that was used to plan with the surgeon, the tumour resection and the new contour of the skull, during the operation when the surgeon has already removed the frontal meningioma and is in the process of inserting our implant, and immediately post-operatively. The patient was discharged home a few days after the operation and was delighted with his vision and cosmetic appearance.

Preparing such a "Two-in-One" operation has clear advantages for the patient and the whole surgical team: from shorter operating time and a shorter anaesthesia to shorter recovery and associated costs.

Furthermore, Cavendish Implants Ltd can provide a cutting guide which fits over the tumour and literally guides the surgeon through the planned resection during the operation.

Back To Top

---