October 2026

NEUROSCIENCES

CUSTOM 3D IMPLANTS ADVANCE RECONSTRUCTION IN COMPLEX SKULL BASE TUMOR SURGERY

Treating spheno-orbital meningiomas presents a unique challenge: Surgeons must not only remove tumor involving the skull base and orbit but also reconstruct the patient's anatomy in a way that preserves vision, restores appearance and maintains function. Because these tumors often infiltrate bone beyond what can be seen on conventional imaging, achieving both goals can be difficult.
 
Northwestern Medicine surgeon-scientists, including senior author Stephen T. Magill, MD, PhD, and Preeti J. Thyparampil, MD, have demonstrated how advanced imaging can be used to design custom 3D cranio-orbital implants tailored to each patient's anatomy and tumor extent. Their findings were recently published in Neurosurgical Focus.
 
Personalized Reconstruction for Complex Tumors
 
Rather than relying on standard reconstruction techniques, the team used DOTATATE-PET and other preoperative imaging studies to design patient-specific polyetheretherketone (PEEK) implants customized to both the patient's anatomy and planned tumor resection. This approach provides a more complete map of tumor involvement, which helps surgeons determine the extent of resection while informing the design of a single implant capable of reconstructing both skull and orbital defects.
 
Integrating Advanced Imaging and 3D Implant Design
 
The multidisciplinary team combined:
  • DOTATATE-PET imaging to identify tumor-infiltrated bone that may not be visible on conventional imaging.
  • Patient-specific 3D PEEK implants designed around each patient's anatomy and planned resection.
  • Expertise from neurosurgery, radiology and ophthalmology specialists to optimize both tumor removal and reconstruction.
 
DOTATATE-PET frequently identified tumor involvement beyond what was visible on CT and MRI alone, directly informing surgical planning and custom implant design.
 
Improved Functional and Reconstructive Outcomes
 
In the published case series, four patients underwent tumor resection followed by reconstruction with a single patient-specific implant. Visual outcomes stabilized or improved in all patients, proptosis improved across the series, and three patients achieved restoration of normal eye position. Investigators reported no implant-related complications.

Integrating DOTATATE-PET with custom cranio-orbital implants offers a practical framework for managing complex spheno-orbital meningiomas while supporting both reconstructive and oncologic goals.
 
Read the study >
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Stephen T. Magill, MD, PhD, Assistant Professor of Neurological Surgery at Northwestern Medicine
Preeti J. Thyparampil, MD, Associate Professor, Ophthalmology at Northwestern Medicine

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Neurosciences, Skull base tumor surgery, 3D Implants, Meningioma surgery, Northwestern Medicine neurosurgery, Northwestern Medicine