Joe Abdel Hay1, Tarek Smayra2, Ronald Moussa3. 1. Department of Neurosurgery, Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon. Electronic address: joe.abdelhay@gmail.com. 2. Department of Radiology, Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon. 3. Department of Neurosurgery, Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon.
Abstract
OBJECTIVES: Prefabricated customized cranioplasty implants are anatomically more accurate than manually shaped acrylic implants but remain costly. The authors describe a new cost-effective technique of producing customized polymethylmethacrylate (PMMA) cranioplasty implants with the use of prefabricated 3-dimensional (3D) printed molds. METHODS: The first patient had a left frontal cranial defect after a craniotomy for a glial tumor. A 3D image of his skull was obtained from axial 0.6-mm computed tomography (CT) scan images. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of his cranium as a model. The second patient had a bifrontal defect after the resection of an infected customized polyetheretherketone implant. A 3D image of the infected implant was directly obtained from an axial 0.6-mm CT scan before discarding it. The images were then used to produce for each patient a mold of the external surface of the cranium using a low-cost polylactic acid 3D printer. Intraoperatively, each mold was put in a sterile bag and then used to cast a customized PMMA implant subsequently trimmed before fixation. RESULTS: Both patients had excellent cosmetic results and underwent postoperative CT scans that showed excellent restoration of the symmetrical contours of the cranium. No neurologic or infectious complications occurred over a 6-month follow-up for either patient. CONCLUSIONS: Making customized PMMA cranioplasty implants via 3D printed polylactic acid molds is a cost-effective technique for delayed reconstruction of various cranial defects.
OBJECTIVES: Prefabricated customized cranioplasty implants are anatomically more accurate than manually shaped acrylic implants but remain costly. The authors describe a new cost-effective technique of producing customized polymethylmethacrylate (PMMA) cranioplasty implants with the use of prefabricated 3-dimensional (3D) printed molds. METHODS: The first patient had a left frontal cranial defect after a craniotomy for a glial tumor. A 3D image of his skull was obtained from axial 0.6-mm computed tomography (CT) scan images. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of his cranium as a model. The second patient had a bifrontal defect after the resection of an infected customized polyetheretherketone implant. A 3D image of the infected implant was directly obtained from an axial 0.6-mm CT scan before discarding it. The images were then used to produce for each patient a mold of the external surface of the cranium using a low-cost polylactic acid 3D printer. Intraoperatively, each mold was put in a sterile bag and then used to cast a customized PMMA implant subsequently trimmed before fixation. RESULTS: Both patients had excellent cosmetic results and underwent postoperative CT scans that showed excellent restoration of the symmetrical contours of the cranium. No neurologic or infectious complications occurred over a 6-month follow-up for either patient. CONCLUSIONS: Making customized PMMA cranioplasty implants via 3D printed polylactic acid molds is a cost-effective technique for delayed reconstruction of various cranial defects.
Authors: Kacper Kroczek; Paweł Turek; Damian Mazur; Jacek Szczygielski; Damian Filip; Robert Brodowski; Krzysztof Balawender; Łukasz Przeszłowski; Bogumił Lewandowski; Stanisław Orkisz; Artur Mazur; Grzegorz Budzik; Józef Cebulski; Mariusz Oleksy Journal: Polymers (Basel) Date: 2022-04-09 Impact factor: 4.967
Authors: Erasmo Barros da Silva Júnior; Afonso Henrique de Aragão; Marcelo de Paula Loureiro; Caetano Silva Lobo; Ana Flávia Oliveti; Rafael Martinelli de Oliveira; Ricardo Ramina Journal: 3D Print Med Date: 2021-02-06
Authors: Wojciech Czyżewski; Jakub Jachimczyk; Zofia Hoffman; Michał Szymoniuk; Jakub Litak; Marcin Maciejewski; Krzysztof Kura; Radosław Rola; Kamil Torres Journal: Materials (Basel) Date: 2022-07-06 Impact factor: 3.748
Authors: Johannes P Pöppe; Mathias Spendel; Christoph Schwartz; Peter A Winkler; Jörn Wittig Journal: Acta Neurochir (Wien) Date: 2021-12-06 Impact factor: 2.816