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A 28-year-old African American female with end-stage renal disease on dialysis secondary to preeclampsia presented to the office as a referral for large multifocal tumors of maxilla and mandible. Surgical pathology and laboratory findings were supportive of secondary hyperparathyroidism leading to multifocal brown tumors. She underwent osteoplasty after using virtual surgical planning to create stereolithic models to visualize the tumor and fabricate cutting guides to minimize the risk of injury to adjacent nerves and teeth. Brown tumors can be resistant to medical management with unreliable regression in size. With the advent of customized surgical guides, more precise and judicious surgery can be performed on these types of tumors safely. more...

Correction of orbito-frontal defects involves a multitude of surgical challenges, and requires careful and detailed planning. In the trauma setting, one must be prepared to deal with injuries to adjacent structures and be able to incorporate their repair into the surgical plan to maximize the functional and esthetic reconstruction for the benefit of the patient. Victims who have sustained trauma of the cranial complex in combination with mid-facial trauma, particularly involving the orbit, present a difficult scenario, especially when future ocular prosthetic rehabilitation is a concern. The authors present a patient of virtual surgical planning-guided planning of mid-facial osteotomies and custom implant creation for the secondary reconstruction of a patient who sustained extensive orbito-frontal trauma, requiring not only cranial vault recontouring, but also reconstruction of the mid-facial and orbital complex to accommodate an ocular prosthesis that would demonstrate proper anatomical relationships to maximize esthetics and function. more...