Rotaru H, Baciut M, Stan H, Bran S, Chezan H, Iosif A, Tomescu M, Kim SG, Rotaru A, and Baciut G
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery [J Craniomaxillofac Surg] 2006 Jun; Vol. 34 (4), pp. 242-6. Date of Electronic Publication: 2006 Apr 27.
Brain Edema surgery, Durapatite, Humans, Imaging, Three-Dimensional methods, Male, Methacrylates, Middle Aged, Prosthesis Design, Silicone Elastomers, Tomography, X-Ray Computed, Bone Plates, Craniotomy instrumentation, and Prostheses and Implants
Introduction: Reconstruction of the cranial vault is performed for various reasons and precise repair of the defect is important. A modified method of cranioplasty is presented using three-dimensional (3D) models and polyethylmethacrylate mixed with hydroxyapatite, cast in a silicone rubber mould. Patient and Method: A large custom made cranial implant was produced using data acquired from 3D computer tomography, rapid prototyping and cast in a silicone rubber mould. This plate was then applied to a 53 year-old man who had undergone a decompressive fronto-parieto-temporo-occipital craniotomy. The bone flap had been lost due to infection. The cranioplasty was performed at 1 year after the initial operation. Results: The cranial plate fitted precisely into the defect and needed no correction at the time of surgery. The stability of the reconstruction plate was increased by the presence of thin margins allowed by silicone rubber elasticity. No complications occurred and the final functional and aesthetic results were good. Conclusion: The use of 3D imaging and rapid prototyping allow precise repair of large skull defects, with good aesthetic and functional results. At the same time, silicone rubber moulds permit the production of very thin details needed not only for cosmetic reasons but for reconstruction plate stability as well.