Customized 3D-printed Poly ether ether ketone cranial implant for cranioplasty of skull defects

Cranioplasty become one of the common surgeries in the neurosurgical field. The complex configuration of the cranium makes the bone reconstruction of the skull defects a challenging procedure. While the patient's own bone flap is the best option, other materials such as titanium and Poly ether ether Ketone (PEEK) were used for cranioplasty when the autogenous flap of the patient is unavailable. Recently, customized 3D printing implants were developed for cranioplasty with favorable outcomes. In this study, we evaluated the outcome of customized 3-dimentional (3D)-printed PEEK implant cranioplasty for reconstructing skull defects, especially large ones. We report a series of 27 patients whose skull defects were reconstructed by a customized 3D-printed PEEK implants. Demographic data and postoperative clinical and imaging findings were reviewed. We analyzed the complications, clinical and aesthetic outcomes during mid-term follow-up. During the surgery, all the implants were perfectly fitted in the skull defect without any major modification. Aesthetic results were satisfactory in 74.1% of patients. 4 patients (14.8%) had complications, including 3 deep cranial infections (11.1%) and one extradural hematoma (3,7%). In 2 patients (7.4%), the implants were removed due to infection. Therefore, when autologous bone is unavailable or, in selected cases with large or complex skull defects, customized 3D-printed PEEK implants could be a proper option to reconstruct these defects.