A clinical case of a combined approach to restoring post-traumatic deformation of the bones of the arch and base of the skull, bones of the middle zone of the face

Abstract

Background. The article is extremely relevant due to growing traumatism, current condition of craniofacial traumatology, debatable and incomplete tactics of restoring traumatic defects and deformations of bones of the skull and face. Plastic surgery of the skull defects has developed from simple defect closure to restoring an aesthetically attractive area of the skull, which shape repeats the individual structure of the area lost due to trauma or surgical treatment (trepanation surgery, osteoplastic trepanation, treatment of a depressed skull fracture, etc.). To restore the defects specialists use auto‑ and allografts. In recent years, materials to manufacture implants are simulated using a 3D‑shape.Aims. To describe the clinical case of a combined approach for the restoration of post‑traumatic deformation of the bones of the arch, base of the skull and bones of the middle zone of the face. To show the importance of multidisciplinary teams in providing assistance to this group of patients, as well as the use of individual 3D simulated titanium plates for reconstructive operations. Emphasize the need to perform reconstructive operations as soon as possible.Materials and methods. Patient Sh., 43 years old, was admitted to the neurosurgical department of the City Clinical Emergency Hospital (Minsk), in the long term severe traumatic brain injury, with defects of the arch and base of the skull and deformation of the bones of the facial skull on the left. Titanium implants were modeled on a 3D printer, which were used during the operation performed by a multidisciplinary team consisting of a neurosurgeon, maxillofacial surgeon and ophthalmologist‑surgeon. Us for closing defects in the cranial vault, the bottom wall of the orbit and in eliminating deformation skeleton midface line. Titanium implants are made by specialists of Medbiotech SP LLC, Minsk, Republic of Belarus.Results. The late postoperative period proceeded without peculiarities, the wounds healed by primary tension. Post-operative CT showed that the condition of the implants is satisfactory.Conclusion. This clinical observation demonstrated the need for a multidisciplinary approach, as well as the priority in using 3D simulated titanium implants to restore post‑traumatic deformation of the bones of the arch and base of the skull and midline bones.