SYNDROME OF THE TREPHINED AND CUSTOM MADE CRANIOPLASTY USING VIRTUAL SURGICAL PLANNING. A SERIES OF 10 CASES

Abstract

Cranial defects often occur after trauma, neurosurgical procedures like decompressive craniotomy, tumor resections, infection and congenital defects. Because prosthesis production is often costly and requires complex intraoperative processes, this paper reviews clinical data of syndrome of the trephined and its treatment by means of cranioplasty with the application of newer technologies such as virtual surgical planning, computer-aided design, as well as computer-aided manufacturing in order to give the opportunity to fabricate custom-made polymethylmethacrylate implants. Implant customized manufacturing for cranioplasty allows for a precise and anatomical reconstruction in a shorter operating time compared to other conventional techniques. We present a simple protocol, low-cost method for prosthesis manufacturing that ensures surgical success. In this case series on 10 patients with cranial defects are presented to describe the digital technique. In an open-source software’s virtual prosthesis is designed and manufactured with the aid of 3D-printing technology. Then the anatomical model, designed plate and the tow molds are printed using a DLP 3D printer, which then is used in a laboratory to cast the final customized prosthesis in polymethyl methacrylate (PMMA).

Keywords

• syndrome of the trephined
• cranioplasty
• polymethylmethacrylate
• virtual surgical planning
• computer-aided design
• computer-aided manufacturing