Introduction. Osteolytic skull lesions pose significant surgical challenges because of their destructive nature and potential involvement of adjacent soft tissues. Complete resection of the affected bone is essential to reduce the risk of recurrence and ensure cranial stability; however this frequently results in large defects that require precise and immediate reconstruction. Advances in three-dimensional printing have enabled patientspecific surgical planning and the creation of customized tools and implants, thereby improving surgical accuracy, operative efficiency, and cosmetic outcomes. Case Report. We present a case of a patient with an osteolytic skull lesion treated using a customized three-dimensional-printed bone resection guide and a polylactic acid mold for intraoperative polymethyl methacrylate cranioplasty. Preoperative computed tomography and magnetic resonance imaging data were used to generate a virtual three-dimensional model, allowing accurate definition of resection margins and precise implant design. This approach enabled controlled lesion excision and immediate reconstruction using a well-fitting polymethyl methacrylate implant. Postoperative imaging confirmed complete lesion resection and optimal implant positioning, with excellent cosmetic and functional outcomes observed at one-year follow-up. Discussion. The integration of three-dimensional printing into cranial reconstructive surgery enhances surgical precision, reduces operative time, and offers a cost-effective method for individualized reconstruction. This case highlights the practical applicability of three-dimensional-printed surgical guides and molds in managing complex osteolytic skull lesions. Conclusion. The use of three-dimensional-printed resection guides combined with intraoperative polymethyl methacrylate molding enables accurate bone resection and immediate cranial reconstruction, achieving high precision, reproducibility, and favorable clinical outcomes.
Rodic et al. (Wed,) studied this question.