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3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects
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Craniofacial reconstruction with poly(methyl methacrylate) customized cranial implants.

Gary J Huang1, Susan Zhong, Srinivas M Susarla

  • 1From the *The University of Illinois College of Medicine, Rockford, Illinois; and Departments of †Plastic and Reconstructive Surgery and ‡Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

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Poly(methylmethacrylate) (PMMA) customized craniofacial implants (CCIs) show a low complication rate for secondary cranioplasty. Future research should focus on implant shape modification to address soft-tissue deformities and improve patient satisfaction.

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Area of Science:

  • Neurosurgery
  • Craniofacial Surgery
  • Biomaterials

Background:

  • Secondary cranioplasty utilizes customized craniofacial implants (CCIs) for cranial defect reconstruction.
  • Polyetheretherketone and poly(methylmethacrylate) (PMMA) are common CCI materials.
  • Previous studies report complications like infection and revision surgeries with CCIs.

Purpose of the Study:

  • To review outcomes of PMMA CCIs in a large case series.
  • To assess the complication rate and identify areas for improvement in PMMA CCI cranioplasty.

Main Methods:

  • A retrospective review of 22 consecutive PMMA CCI cranioplasties in 20 patients over 2 years.
  • Statistical analysis of initial insult, time to cranioplasty, anesthesia, complications, radiation, and follow-up.

Main Results:

  • No infections, hematomas, or CSF leaks were observed (0/22).
  • Two patients (9%) experienced persistent temporal hollowing (PTH) requiring revision surgery.
  • One patient (5%) had transient diplopia.

Conclusions:

  • PMMA CCIs demonstrated a low complication rate in this series.
  • Persistent temporal hollowing (PTH) and asymmetry affected patient satisfaction.
  • Modifying CCI shape is crucial for addressing soft-tissue deformities and improving outcomes.