Case report: One-stage craniectomy and cranioplasty digital workflow for three-dimensional printed polyetheretherketone implant for an extensive skull multilobular osteochondosarcoma in a dog

Marc Hobert; Neha Sharma; Caroline Benzimra; Sandro Hinden; Anna Oevermann; Michaela Maintz; Michel Beyer; Florian Thieringer; Julien Guevar

doi:10.3389/fvets.2024.1459272

Case report: One-stage craniectomy and cranioplasty digital workflow for three-dimensional printed polyetheretherketone implant for an extensive skull multilobular osteochondosarcoma in a dog

Front Vet Sci. 2024 Aug 29:11:1459272. doi: 10.3389/fvets.2024.1459272. eCollection 2024.

Authors

Marc Hobert^#¹, Neha Sharma^#^{2

3}, Caroline Benzimra⁴, Sandro Hinden¹, Anna Oevermann⁵, Michaela Maintz^{2

3

6}, Michel Beyer^{2

3}, Florian Thieringer^{2

3}, Julien Guevar¹

Affiliations

¹ AniCura Tierklinik Thun, Thun, Switzerland.
² Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
³ Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
⁴ Vetpixel SAS, Kochersberg, France.
⁵ Division of Neurological Sciences, DCR-VPH, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
⁶ Institute for Medical Engineering and Medical Informatics IM2, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland.

^# Contributed equally.

Abstract

Objective: To report a digital workflow for use and long-term outcome of cranioplasty with a 3D-printed patient-specific Polyetheretherketone (PEEK) implant in a 12-y-old German Shepherd dog after surgical removal of an extensive occipital bone multilobular osteochondrosarcoma (MLO).

Study design: Retrospective case report.

Animal: A 12-year-old neutered female German Shepherd dog was presented with facial deformity, blindness, tetraparesis, and ataxia. Magnetic resonance imaging (MRI) and computed tomography (CT) identified a large skull-based mass extending extra-and intracranially with severe compression of the cerebellum and occipital lobes of the cerebrum.

Methods: One-stage decompressive craniectomy using virtual surgical planned 3D-printed craniotomy cutting guides and the Misonix BoneScalpel^® and reconstruction with a patient-specific 3D-printed PEEK cranial implant.

Results: 3D-printed craniectomy cutting guides allowed an adequate fit of the cranial implant to the original skull. Misonix BoneScalpel^® allowed performing a safe and extensive craniectomy. Postoperative CT (8 weeks after surgery) confirmed the PEEK cranial implant to be in place and without implant rejection. Clinically, the neurological examination identified only a right-hind limb delay in proprioception 8 weeks postoperatively, which remained unchanged at 18 months after surgery. Adjunctive treatment included metronomic chemotherapy. Eighteen months after surgery the dog passed away for reasons unrelated to the MLO, no implant-related complications were reported.

Conclusion: 3D-printed craniectomy cutting guides, patient-specific PEEK cranial implant, and metronomic chemotherapy can lead to a successful long-term outcome in dogs with extensive skull MLO.

Clinical significance: PEEK is an alternative biomaterial that can be used successfully for skull reconstruction.

Keywords: PEEK-polyether ether ketone; craniectomy; craniotomy; dog; multilobular osteochondroma.

Publication types

Case Reports

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was funded by the Innovation Focus Regenerative Surgery of the University Hospital Basel and by the Werner Siemens Foundation through the Minimally Invasive Robot-Assisted Computer-guided LaserosteotomE II (MIRACLE II) project.