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Published on: May 23, 2020
Simultaneous repair of two large cranial defects using rapid prototyping and custom computer-designed titanium
D A Morrison1, D T Guy, R E Day
1Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Australia. david.morrison@health.wa.gov.au
Summary
Custom titanium plates repaired extensive cranial defects in a patient with intractable epilepsy. This innovative computer-aided design and manufacturing approach ensured an excellent fit and cosmetic outcome.
Area of Science:
- Neurosurgery
- Biomedical Engineering
Background:
- Custom titanium cranioplasty plates are utilized for cranial defect repair.
- Medically intractable epilepsy can necessitate complex surgical interventions and subsequent reconstructions.
Observation:
- A 28-year-old woman with intractable epilepsy underwent corpus callosotomy, complicated by hemorrhage and infection requiring bilateral bone flap removal.
- This resulted in extensive, bilateral, and asymmetrical cranial defects, posing a significant reconstructive challenge.
Findings:
- A unique methodology involving simultaneous design and fabrication of two custom computer-designed titanium plates was employed.
- Utilizing computed tomography (CT) scan data, a rapid-prototype skull model was created, and virtual surfaces generated for defect reconstruction.
- The simultaneous implantation of both custom titanium cranial plates was performed efficiently with no intra-operative complications and achieved an excellent fit.
Implications:
- This case demonstrates a successful and efficient method for reconstructing complex cranial defects using custom, computer-designed titanium plates.
- The described methodology offers a viable solution for challenging cranioplasty cases, achieving excellent cosmetic results.
- Advanced computer-aided design and manufacturing techniques are crucial for optimizing outcomes in reconstructive neurosurgery.
