RESUMO
BACKGROUND: Single-stage surgical treatment of cranial intraosseous meningiomas includes complete tumor resection followed by aesthetic reconstruction. Tailored tumor resection with a computer-aided design/computer-aided manufacturing custom-made implant for the defect has been advocated in recent years to achieve a satisfactory cosmetic result with reduced operative time and fewer complications. However, several technical nuances related to the area of osseous removal may compromise cranioplasty. METHODS: We present 2 cases of intraosseous meningiomas (sphenoid wing and retromastoid) to illustrate a step-by-step approach, from preoperative planning to single-step surgery. RESULTS: For each case, a customized frame template delimiting bone removal was designed using cranial sutures as anatomical landmarks for precise placement of the cranioplasty template over the area of interest. CONCLUSIONS: Custom templates based in cranial sutures may benefit single-step frame-guided resection and reconstruction of intraosseous tumors with compelling results.