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Customized anterior temporal augmentation for treating anterior temporal hollowing (ATH) by 3D-printed cranioplasty
1Division of Neurosurgery, Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, 2 Phayathai Road, Ratchathewi district, 10400 Bangkok, Thailand.
Background:
Anterior temporal hollowing (ATH) leads to unattractive facial asymmetry and significant distress for the patient. This study aimed to correct ATH by a prefabricated cranioplasty using soft-tissue volume augmentation created by 3D printing and to evaluate the esthetic improvement.
Methods:
This prospective study was conducted on 19 patients with ATH after brain surgery. Quantitative assessment used Materialized Mimics® and Images® to compare defect volume and quantitative measurement of the "defect value" pre- and post-PMMA implantation. Qualitative assessment was rated by patients on VAS pre- and 6 months post-surgery.
Results:
The mean defect value decreased significantly with the innovative PMMA implant, from 2.42 ± 0.57 cm to 0.57 ± 0.45 cm (p < 0.01). There was a statistically significant reduction between pre- and postoperative defect value: 1.85 ± 0.48 (p < 0.01; 95% CI 2.08-1.61). After PMMA cranial implantation, 100% of patients reported esthetic improvement, 79% (15 out of 20) rating their esthetic improvement with the highest possible VAS score: mean VAS rating, 0.84 ± 1.2 preoperatively, and 4.63 ± 0.83 postoperatively, for a significant mean improvement of 3.789 ± 1.273 (p < 0.01; 95% CI 3.176-4.403).
Conclusions:
The innovative PMMA cranial implants created by advanced customized 3D technology successfully managed ATH. This could be a therapeutic alternative for correcting ATH and can be routinely employed in clinical practice.
