3D Printing Enables Customized PEEK Implants for Cranio-Orbital Reconstruction

Overview

This study reports on 11 female patients undergoing single-step resection of benign spheno-orbital tumors with immediate cranio-orbital reconstruction using customized polyetheretherketone (PEEK) implants designed via 3D printing and CAD/CAM technology. The approach facilitated precise tumor resection and rigid orbital reconstruction, addressing complex anatomy and preserving visual function.

Background

Spheno-orbital tumors with infiltration pose surgical challenges due to complex orbital anatomy and risk to optic nerve function. Rigid reconstruction of the orbit is critical to prevent malalignment and exophthalmos, especially when multiple orbital walls are resected. Traditional reconstruction materials include bone grafts and biomaterials, but CAD/CAM implants tailored to patient anatomy offer improved aesthetics and protection without donor site morbidity. Advances in digital planning and 3D printing enable precise preoperative design of implants and cutting guides, optimizing surgical outcomes.

Data Highlights

Key Findings

• Single-step resection and reconstruction using CAD/CAM PEEK patient-specific implants (PSIs) is feasible for benign spheno-orbital tumors.
• Preoperative planning utilized multimodal imaging (CT, MRI, PET/CT) integrated into Brainlab Elements software for precise tumor and bone margin delineation.
• 3D printed cutting guides and implants allowed intraoperative navigation and accurate implant placement, verified by intraoperative imaging.
• Rigid orbital reconstruction prevented malalignment and supported restoration of orbital volume, addressing exophthalmos.
• Interdisciplinary collaboration between neurosurgery and maxillofacial surgery was essential for optimizing oncological and functional outcomes.
• All patients were female with a median age of 52.2 years; most presented with exophthalmos and some had prior surgeries or radiotherapy.

Clinical Implications

The integration of 3D printing and CAD/CAM technology for customized PEEK implants enables precise, rigid reconstruction of complex cranio-orbital defects following tumor resection. This approach minimizes risks to visual function and improves aesthetic outcomes, supporting its use in multidisciplinary skull base surgery. Preoperative virtual planning and intraoperative navigation are critical to achieving optimal implant fit and surgical success.

Conclusion

Customized 3D printed PEEK implants facilitate effective single-stage cranio-orbital reconstruction after benign spheno-orbital tumor resection, combining oncological control with functional and aesthetic restoration. This technique exemplifies personalized medicine in complex skull base surgery.

References

1. Neuro-oncologic pathologies and reconstruction challenges [12,14,18]
2. CAD/CAM implant advantages and prior reports [6,8,16,18,26]
3. 3D printing and virtual planning workflow [2,3,6,7,8,11]