Customized Cranioplasty Implants Using Three-Dimensional Printers and Polymethyl-Methacrylate Casting.
10.3340/jkns.2012.52.6.541
- Author:
Bum Joon KIM
1
;
Ki Sun HONG
;
Kyung Jae PARK
;
Dong Hyuk PARK
;
Yong Gu CHUNG
;
Shin Hyuk KANG
Author Information
1. Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea. hermes23@kumc.or.kr
- Publication Type:Original Article
- Keywords:
Decompressive craniectomy;
Reconstructive surgical procedure;
Computer-aided design;
Polymethyl-methacrylate
- MeSH:
Computer-Aided Design;
Decompressive Craniectomy;
Follow-Up Studies;
Fungi;
Humans;
Methylmethacrylate;
Polymethyl Methacrylate;
Reconstructive Surgical Procedures;
Skull;
Tomography, Spiral Computed
- From:Journal of Korean Neurosurgical Society
2012;52(6):541-546
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The prefabrication of customized cranioplastic implants has been introduced to overcome the difficulties of intra-operative implant molding. The authors present a new technique, which consists of the prefabrication of implant molds using three-dimensional (3D) printers and polymethyl-methacrylate (PMMA) casting. METHODS: A total of 16 patients with large skull defects (>100 cm2) underwent cranioplasty between November 2009 and April 2011. For unilateral cranial defects, 3D images of the skull were obtained from preoperative axial 1-mm spiral computed tomography (CT) scans. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of the cranium as a model. For bilateral cranial defects, precraniectomy routine spiral CT scan data were merged with postcraniectomy 3D CT images following a smoothing process. Prefabrication of the mold was performed by the 3D printer. Intraoperatively, the PMMA implant was created with the prefabricated mold, and fit into the cranial defect. RESULTS: The median operation time was 184.36+/-26.07 minutes. Postoperative CT scans showed excellent restoration of the symmetrical contours and curvature of the cranium in all cases. The median follow-up period was 23 months (range, 14-28 months). Postoperative infection was developed in one case (6.2%) who had an open wound defect previously. CONCLUSION: Customized cranioplasty PMMA implants using 3D printer may be a useful technique for the reconstruction of various cranial defects.
