Breaking Barriers in Cranioplasty: 3D Printing in Low and Middle-Income Settings—Insights from Zenica, Bosnia and Herzegovina

Abstract

Background and Objectives: Cranial defects pose significant challenges in low and middle-income countries (LIMCs), necessitating innovative and cost-effective craniofacial reconstruction strategies. The purpose of this study was to present the Bosnia and Herzegovina model, showcasing the potential of a multidisciplinary team and 3D-based technologies, particularly PMMA implants, to address cranial defects in a resource-limited setting. Materials and Methods: An observational, non-experimental prospective investigation involved three cases of cranioplasty at the Department of Neurosurgery, Cantonal Hospital Zenica, Bosnia and Herzegovina, between 2019 and 2023. The technical process included 3D imaging and modeling with MIMICS software (version 10.01), 3D printing of the prototype, mold construction and intraoperative modification for precise implant fitting. Results: The Bosnia and Herzegovina model demonstrated successful outcomes in cranioplasty, with PMMA implants proving cost-effective and efficient in addressing cranial defects. Intraoperative modification contributed to reduced costs and potential complications, while the multidisciplinary approach and 3D-based technologies facilitated accurate reconstruction. Conclusions: The Bosnia and Herzegovina model showcases a cost-effective and efficient approach for craniofacial reconstruction in LIMICs. Collaborative efforts, 3D-based technologies, and PMMA implants contribute to successful outcomes. Further research is needed to validate sustained benefits and enhance craniofacial reconstruction strategies in resource-constrained settings.

Augmented Reality Integration in Skull Base Neurosurgery: A Systematic Review

“…The use of AR in SB surgery is at a specific stage of development. On the one hand, there are obvious advantages that real-time 3D technology offers to surgeons in optimizing procedures related to SB surgery [14,[78][79][80]. On the other hand, this promising technology currently has its limitations, which are reflected in the current development of the equipment itself [81], the training of staff to use these new techniques [82], and the inaccessibility in less-developed countries or countries whose health systems are less able to follow the technological development of medical services [83].…”

A Case of Trigeminal Neuralgia in an Adult Patient With Lambdoid Synostosis

“…Bečulić et al reported the usefulness of preoperative planning with three-dimensional (3D) printing in surgical treatments for craniofacial reconstruction patients [ 11 ]. Advances in 3D imaging and printing can aid in more accurate and safer procedures for patients.…”