Abstract:

ACKGROUND: Traditional method of cranioplasty has disadvantages such as modeling and shaping for long time in-operation, and the result depends on the experience of the performer. Since the computer aided design and rapid prototyping technology introducing to cranial maxillofacial surgery, the cranial defect reconstruction of individual design and 3-dimentional simulation become possible.
OBJECTIVE: To evaluate the clinical efficacy of computer-aided design/computer-aided manufacturing of individual titanium implant in repairing post-traumatic cranial defect.
METHODS: Data acquisition was performed by electron beam computed tomography, and data transferring was performed by on-line telecommunication systems to work-station, where the 3D geometric model of skull defect was established. A geometric shaped patch was designed by intellectual technology. The solid model by the rapid prototyping technique was made and the individual titanium implant was manufactured by casting. The routine surgical repair was performed. Total 26 patients who suffered from post-traumatic cranial defect were treated and cured. The defect area was ranged from 6 cm×8 cm to 12 cm×15 cm.
RESULTS AND CONCLUSION: All wound healed primarily. Prosthetic replacement well matched defect. No correction or fixation was required in operation. During the followed up of 1-4 years, the appearances of cranium looked beautiful and symmetric, with no infection, or titanium plate exposed. Compared with the conventional manual cranioplasty, the individualized titanium implant prefabricated by computer-aided design/computer-aided manufacturing technique has many advantages, such as simple operation, natural curve similar to the shape of the original cranium, no need of intraoperative reshaping and few complications.