“Two-in-One” operation with prefabricated PSI 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 (titanium), or can be trimmed back (PEEK).

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.