Morrison D A, Guy D T, Day R E, Lee G Y F
Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Australia.
Proc Inst Mech Eng H. 2011 Nov;225(11):1108-12. doi: 10.1177/0954411911422766.
Custom titanium cranioplasty plates, manufactured by a variety of techniques, have been used to repair a range of cranial defects. The authors present a case where two relatively large, adjacent cranial defects were repaired by custom computer-designed titanium plates. The two plates were designed and fabricated simultaneously using a unique methodology. A 28-year-old woman underwent a corpus callosotomy for medically intractable epilepsy. The surgery was complicated by unexpected haemorrhage which necessitated a second craniotomy. Subsequent deep infection required the removal of bilateral bone flaps, presenting a challenge in the reconstruction of extensive, bilateral but asymmetrical cranial defects. The patient underwent a head computed tomography scan, from which a rapid-prototype model of the skull was produced. The surfaces for the missing cranial segments were generated virtually using a combination of software products and two titanium plates that followed these virtual contours were manufactured to cover the defects. The cranioplasty procedure to implant both titanium cranial plates was performed efficiently with no intra-operative complications. Intra-operatively, an excellent fit was achieved. The careful planning of the plates enhanced the relative ease with which the cranial defects were repaired with an excellent cosmetic outcome.
通过多种技术制造的定制钛颅骨修补板已被用于修复一系列颅骨缺损。作者介绍了一个病例，其中两个相对较大的相邻颅骨缺损通过定制的计算机设计钛板进行修复。这两个板采用独特的方法同时设计和制造。一名28岁女性因药物难治性癫痫接受了胼胝体切开术。手术因意外出血而复杂化，这需要进行第二次开颅手术。随后的深部感染需要移除双侧骨瓣，这给广泛的、双侧但不对称的颅骨缺损重建带来了挑战。患者接受了头部计算机断层扫描，由此制作了颅骨的快速原型模型。使用软件产品组合虚拟生成缺失颅骨部分的表面，并制造了两个遵循这些虚拟轮廓的钛板来覆盖缺损。植入两个钛颅骨板的颅骨成形术高效完成，术中无并发症。术中实现了极佳的贴合度。对板的精心规划提高了修复颅骨缺损的相对容易程度，并取得了极佳的美容效果。
