Surgical results of cranioplasty using three-dimensional printing technology

• Published in: Clinical neurology and neurosurgery Vol. 168; pp. 118 - 123
• Main Authors: Cheng, Cheng-Hsin, Chuang, Hao-Yu, Lin, Hung-Lin, Liu, Chun-Lin, Yao, Chun-Hsu
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.05.2018; Elsevier Limited
• Subjects: 3-D printers; 3-D printing; Adult; Aged; Anesthesia; Bone Cements; Bone resorption; Brain surgery; Complications; Computed tomography; Craniofacial surgery; Cranioplasty; Craniotomy - methods; Defects; Effusion; Ethics; Exposure; Female; Hospitals; Humans; Infections; Male; Middle Aged; Neurology; Peritoneum; Polymethyl methacrylate; Polymethylmethacrylate; Postoperative Complications - surgery; Printing, Three-Dimensional; Prostheses and Implants; Reconstruction; Reconstructive Surgical Procedures - methods; Rubber; Silicones; Skull; Skull - surgery; Software; Surgical Wound Infection - surgery; Symmetry; Technicians; Technology; Transplants & implants; Trauma; Treatment Outcome; Belgium; United States > US; China; Taiwan; 3-D printing; Cranioplasty; Polymethyl methacrylate; Craniofacial surgery
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2018.03.004

•The three-dimnensional printing technology is precise, fast, and inexpensive.•This technique may be beneficial for clinical application.•This individualized prefabrication achieve precise and excellent symmetry. The aim of this research was to evaluate the surgical outcome of a new three-dimensional printing (3DP) technique using prefabrication molds and polymethyl methacrylate (PMMA). The study included 10 patients with large skull defects (>100 cm2) who underwent cranioplasty. The causes of the skull defects were trauma (6), bone resorption (2), tumor (1), and infection (1). Before the operation, computed tomography (CT) scans were used to create a virtual plan, and these were then converted to 3-dimensional (3-D) images. The field of the skull defect was blueprinted by the technicians and operators, and a prefabricated 3-D model was generated. During the operation, a PMMA implant was created using a prefabricated silicone rubber mold and fitted into the cranial defect. All patients were followed up for at least 2 years, and any complications after the cranioplasty were recorded. Only 1 patient suffered a complication, subdural effusion 2 months after cranioplasty, which was successfully treated with a subdural peritoneal shunt. All patients satisfied the criteria for operative outcome and cosmetic effect. There were no episodes of infection or material rejection. The 3DP technology allowed precise, fast, and inexpensive craniofacial reconstruction. This technique may be beneficial for shortening the operation time (and thus reducing exposure time to general anesthesia, and wound exposure time, and blood loss), enhancing preoperative evaluation and simplifying the surgical procedure.