A simplified technique for polymethyl methacrylate cranioplasty: combined cotton stacking and finger fracture method.

PRIMARY OBJECTIVE

Polymethyl methacrylate (PMMA) is one of the most frequently used cranioplasty materials. However, limitations exist with PMMA cranioplasty including longer operative time, greater blood loss and a higher infection rate. To reduce these disadvantages, it is proposed to introduce a new surgical method for PMMA cranioplasty.

RESEARCH DESIGN

Retrospective review of nine patients who received nine PMMA implants using combined cotton stacking and finger fracture method from January 2008 to July 2011.

METHODS AND PROCEDURES

The definitive height of skull defect was quantified by computer-based image analysis of computed tomography (CT) scans. Aesthetic outcomes as measured by post-reduction radiographs and cranial index of symmetry (CIS), cranial nerve V and VII function and complications (wound infection, hardware extrusions, meningitis, osteomyelitis and brain abscess) were evaluated.

MAIN OUTCOMES AND RESULTS

The mean operation time for implant moulding was 24.56 ± 4.6 minutes and 178.0 ± 53 minutes for skin-to-skin. Average blood loss was 169 mL. All post-operative radiographs revealed excellent reduction. The mean CIS score was 95.86 ± 1.36%, indicating excellent symmetry.

CONCLUSIONS

These results indicate the safety, practicability, excellent cosmesis, craniofacial symmetry and stability of this new surgical technique.