Evaluation of locally manufactured patient-specific custom made implants for cranial defects using a silicone mould
Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Health and Medical Publishing Group
Abstract
Background: Cranial vault defects can pose a significant problem for neurosurgeons where autologous bone is no longer
available for cranioplasty. Numerous materials exist to create implants which include polymethyl methacrylate (PMMA)
and titanium. A technique using 3-dimensional CT scan reconstruction of a cranial defect and creating a silicon mould which
can be autoclaved in theatre to create a PMMA implant was developed.
Objectives: The aim of this study is to evaluate the efficacy, cosmetic result, safety and cost-effectiveness of this procedure
and compare this to existing techniques.
Methods: An ambispective study was performed in patients requiring cranioplasty with a custom made implant. Patients
were assessed for risk factors and cosmetic outcome, surgical technique was described and complications and cost compared
to existing literature between 2010 and 2016.
Results: Thirty retrospective and 30 consecutive prospective patients were recruited into the study. Overall sepsis rate was
8.3%. All septic cases had superficial sepsis of which 2 grafts were removed due to cerebrospinal fluid leakage resulting in
wound breakdown. A 100% accurate implant to defect ratio was achieved leading to a high satisfaction rate. Average cost
was 5 times cheaper than the closest market related product.
Conclusion: Patient specific moulds using PMMA to create custom implants are safe, have excellent cosmetic results and
are a very cost-effective option to manage cranial defects. Accurate planning strategies for large craniotomies, where bone
will potentially be discarded, add to surgical effectiveness and cost-saving to the patient.
Description
CITATION: Vlok, A. J. & Naidoo, S. 2018. Evaluation of locally manufactured patient-specific custom made implants for cranial defects using a silicone mould. South African Journal of Surgery, 56(3):38-42, doi:10.17159/2078-5151/2018/v56n3a2521.
The original publication is available at http://www.scielo.org.za
The original publication is available at http://www.scielo.org.za
Keywords
Cranial defects, Neurosurgeons, Cranial manipulation, Implants, Artificial, Silicones in surgery
Citation
Vlok, A. J. & Naidoo, S. 2018. Evaluation of locally manufactured patient-specific custom made implants for cranial defects using a silicone mould. South African Journal of Surgery, 56(3):38-42, doi:10.17159/2078-5151/2018/v56n3a2521