Titanium Three-Dimensional Printed Cranioplasty for Fronto-Nasal Bone Defect

To analyze the characteristics and outcome of patients who underwent the insertion of a 3-dimensional (3D) printed titanium (Materialise) cranioplasty.

Surgical and clinical data of patients who underwent 3D printed titanium cranioplasty insertion at our institution were retrospectively reviewed.

A retrospective search identified 19 cases of titanium cranioplasty insertion between 2012 and 2018. 12 patients were male (63.2%) and mean age at cranioplasty was 47.4 ± 11.3 years. 9 patients had the cranioplasty inserted during the very same procedure of the craniectomy and 10 at a separate surgical stage from the craniectomy. Median delay from the craniectomy until the prosthesis insertion was 0.6 years, interquartile range (IQR) [0.4, 0.9]. Side of cranioplasty insertion was right in 6 cases and in the midline frontal in 9. Median surface of the implant was 68.1 cm, IQR [53, 125.4]. Median follow-up since the cranioplasty insertion was 1.2 year, IQR [0.4, 2.1]. At data collection, 1 patient was lost to follow-up, 1 had its cranioplasty taken out but, none was reported dead. 6 patients (31.6%) experienced early post-operative complications following the cranioplasty insertion. One patient had its cranioplasty removed 2.5 years after the insertion for tumoral recurrence (hemagiopericytoma) and skin necrosis leading to the plate exposure.

3D printed titanium cranioplasty are useful for complex craniofacial reconstruction regardless the etiology of the skull defect. This device is not associated with a higher rate of complication.