Utilizing 3D-printed Jigsaw Puzzle Surgical Guide and Frozen Autograft for Pediatric Craniofacial Tumor...

Pediatric midfacial tumor reconstruction is challenging due to complex anatomy and the need to preserve growth potential. This study presented a novel approach using a 3D-printed surgical guide jigsaw puzzle model and recycled frozen autografts for precise, minimally invasive reconstruction. A 6-year-old boy with spindle cell sarcoma of the right zygomatic bone underwent neoadjuvant chemotherapy before surgery. Preoperative computed tomography imaging and computer-assisted planning determined the resection margin. A polylactide 3-dimensional-printed skull model facilitated preoperative simulation, whereas a stereolithography-fabricated, 5-piece surgical guide enabled precise osteotomy through minimal incisions. The tumor-bearing bone was treated with liquid nitrogen cryotherapy and reimplanted as a recycled autograft. At 20 months postoperatively, the patient demonstrated symmetrical facial appearance, intact sensation, and no visible scarring. Imaging confirmed graft survival, osteotomy healing, and no recurrence. This technique offers an effective, tissue-sparing solution for pediatric craniofacial reconstruction, enhancing precision while minimizing morbidity.