Splavski Bruno, Lakicevic Goran, Kovacevic Marko, Godec Damir
Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Department of Neurosurgery, Mostar University Hospital, Mostar, Bosnia and Herzegovina, Osijek, Croatia.
Surg Neurol Int. 2022 Apr 22;13:169. doi: 10.25259/SNI_1239_2021. eCollection 2022.
Manufacturing of customized three-dimensional (3D)-printed cranioplastic implant after decompressive craniectomy has been introduced to overcome the difficulties of intraoperative implant molding. The authors present and discuss the technique, which consists of the prefabrication of silicone implant mold using additive manufacturing, also known as 3D printing, and polymethyl methacrylate (PMMA) implant casting.
To reconstruct a large bone defect sustained after decompressive craniectomy due to traumatic brain injury (TBI), a 3D-printed prefabricated mold template was used to create a customized PMMA implant for cranial vault repair in five consecutive patients.
A superb restoration of the symmetrical contours and curvature of the cranium was achieved in all patients. The outcome was clinically and cosmetically favorable in all of them.
Customized alloplastic cranioplasty using 3D-printed prefabricated mold for casting PMMA implant is easy to perform technique for the restoration of cranial vault after a decompressive craniectomy following moderate-to-severe TBI. It is a valuable and modern technique to advance manufacturing of personalized prefabricated cranioplastic implants used for the reconstruction of large skull defects having complex geometry. It is a safe and cost-effective procedure having an excellent cosmetic outcome, which may considerably decrease expenses and time needed for cranial reconstructive surgery.
减压性颅骨切除术后定制三维（3D）打印颅骨修复植入物的制造技术已被引入，以克服术中植入物塑形的困难。作者介绍并讨论了该技术，该技术包括使用增材制造（也称为3D打印）预制硅胶植入模具以及聚甲基丙烯酸甲酯（PMMA）植入物铸造。
为了修复因创伤性脑损伤（TBI）导致减压性颅骨切除术后出现的大面积骨缺损，连续5例患者使用3D打印预制模具模板制作定制的PMMA植入物用于颅顶修复。
所有患者的颅骨对称轮廓和曲率均得到了极好的恢复。所有患者的临床和美容效果均良好。
使用3D打印预制模具铸造PMMA植入物进行定制异体颅骨成形术，是一种在中重度TBI减压性颅骨切除术后恢复颅顶的简便技术。它是一种有价值的现代技术，可推动用于重建具有复杂几何形状的大型颅骨缺损的个性化预制颅骨修复植入物的制造。这是一种安全且具有成本效益的手术，具有出色的美容效果，可大幅降低颅骨重建手术所需的费用和时间。
