CAD/CAM-assisted ablative surgery and intraoperative brachytherapy for pediatric skull-base sarcomas Journal Article


Authors: Lopez, J.; Subramanian, T.; Stambuk, H.; Schreyer, M.; Woods, R.; Scholfield, D.; Wong, R.; Cohen, M. A.; Shah, J.; Ganly, I.
Article Title: CAD/CAM-assisted ablative surgery and intraoperative brachytherapy for pediatric skull-base sarcomas
Abstract: Background: Head and neck (H&N) sarcomas in children can poise numerous challenges to the surgical oncologist and require multidisciplinary input and meticulous surgical planning. The application of computer-assisted design/computer-assisted manufacturing (CAD/CAM) has been extensively examined in H&N reconstruction in adults, but its utility in ablative oncologic surgery in children warrants further examination. We present preliminary results utilizing CAD/CAM techniques to assist in planning tumor resections and the application of intra-operative radiation in children with skull-base sarcomas. Methods: A retrospective cohort review of all pediatric patients who presented to a tertiary care cancer center for surgical resection of a skull-base malignancy was performed between 1980 and 2021. All children under 18 years of age with diagnosis of a skull-base sarcoma as confirmed with imaging and pathology were analyzed. Results: A total of 21 children were identified but only four children with skull-base sarcomas had diagnostic imaging available in whom computer-assisted volumetric analyses were generated. In these cases, CAD/CAM was used to plan surgical approaches and intraoperative radiotherapy, significantly aiding in treatment for these complicated pediatric cases. Conclusion: CAD/CAM planning for oncologic resection has huge potential. Here we have shown its utility in pre-operative surgical planning and for administration of intraoperative radiation therapy. Future studies are needed to examine its value in facilitating intraoperative surgical management and patient outcomes, as well as cost effectiveness. © 2023 Wiley Periodicals LLC.
Keywords: adolescent; adult; child; retrospective studies; case report; plastic surgery; retrospective study; sarcoma; head and neck neoplasms; brachytherapy; skull base; head and neck tumor; pediatrics; surgery, computer-assisted; skull; computer aided design; computer assisted surgery; computer-aided design; humans; human; cad/cam; plastic surgery procedures; operative techniques
Journal Title: Head & Neck
Volume: 45
Issue: 12
ISSN: 1043-3074
Publisher: John Wiley & Sons, Inc.  
Date Published: 2023-12-01
Start Page: E61
End Page: E66
Language: English
DOI: 10.1002/hed.27534
PUBMED: 37814997
PROVIDER: scopus
PMCID: PMC11187774
DOI/URL:
Notes: Article -- MSK corresponding author is Ian Ganly -- Source: Scopus
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MSK Authors
  1. Hilda Stambuk
    48 Stambuk
  2. Richard J Wong
    412 Wong
  3. Ian Ganly
    430 Ganly
  4. Jatin P Shah
    721 Shah
  5. Marc A Cohen
    130 Cohen
  6. Joseph Lopez
    14 Lopez
  7. Robbie Seton Rowan Woods
    12 Woods