Multimaterial 3D printing preoperative planning for frontoethmoidal meningoencephalocele surgery

Surgical correction of frontoethmoidal meningoencephalocele, although rare, is still challenging to neurosurgeons and plastic reconstructive surgeons. It is fundamental to establish reliable and safe surgical techniques. The twenty-first century has brought great advances in medical technology, and the 3D models can mimic the correct tridimensional anatomical relation of a tissue organ or body part. They allow both tactile and spatial understanding of the lesion and organ involved. The 3D printing technology allows the preparation for specific surgery ahead of time, planning the surgical approach and developing plans to deal with uncommon and high-risk intraoperative scenarios. The present report describes a case of frontoethmoidal encephalocele, (nasofrontal subtype) of a 19-month-old girl, whose surgical correction was planned using 3D printing modeling. The 3D model allowed a detailed discussion of the aspects of the surgical approach by having tissues of different consistencies and resistances, and also predicting with millimetric precision the bilateral orbitotomy measurements. Moreover, it was a fundamental and valuable factor in the multidisciplinary preoperative discussion. This approach allowed reducing the time of surgery, accurately planning the location of the osteotomies and precontouring the osteosynthesis material. 3D models can be very helpful tools in planning complex craniofacial operative procedures.