Review of Functional Cranioplasty and Implantable Neurotechnology

Cranioplasty for secondary reconstruction of cranial defects has historically focused on simply replacing the missing cranial bone to restore cerebral protection and fluid dynamics, but recent innovations have led to the development of customized cranial implants that address both bone and soft tissue deficits while avoiding postoperative complications such as temporal hollowing. In addition, customized cranial implants have incorporated implantable neurotechnology like ventriculostomy shunts, intracranial pressure monitoring devices, and medicine delivery systems within low-profile designs to convert previously "basic" implants into "smart" implants for added functionality. These "smart" implants aim to reduce complications and improve patient outcomes by leveraging the cranial space to house advanced technologies, providing benefits such as real-time biosensing, and treatment of chronic neurological conditions. This review outlines the progression of cranioplasty from basic bone replacement to functional implants with embedded neurotechnologies, highlighting the multidisciplinary approaches that enhance surgical outcomes and patient quality of life.