Cranioplasty Using Customized 3-Dimensional–Printed Titanium Implants: An International Collaboration Effort to Improve Neurosurgical Care

Nguyen, Bach T.; Ashraf, Omar; Richards, Robin R.; Tra, Hoanh; Huynh, Trong

doi:10.1016/j.wneu.2021.02.104

Cited by 13 publications

(12 citation statements)

References 25 publications

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“…It presents several advantages such as low risk of infection, at a rate of 2.6% in respect to the other materials used for cranioplasty [ 9 , 28 ], it is non corrosive and noninflammatory and it provides very good cosmetic results. Further, due to the latest 3D computer-assisted technology, it is possible to model excellent titanium mesh implants in a number of different structural forms, also for large cranial defects [ 35 ]. Those Ti mesh are placed over the defect and secured to the surrounding bone by screws.…”

Section: Discussion On Cranioplasty Materialsmentioning

confidence: 99%

State-of-Art of Standard and Innovative Materials Used in Cranioplasty

2021

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Cranioplasty is the surgical technology employed to repair a traumatic head injury, cerebrovascular disease, oncology resection and congenital anomalies. Actually, different bone substitutes are used, either derived from biological products such as hydroxyapatite and demineralized bone matrix or synthetic ones such as sulfate or phosphate ceramics and polymer-based substitutes. Considering that the choice of the best material for cranioplasty is controversial, linked to the best operation procedure, the intent of this review was to report the outcome of research conducted on materials used for such applications, comparing the most used materials. The most interesting challenge is to preserve the mechanical properties while improving the bioactivity, porosity, biocompatibility, antibacterial properties, lowering thickness and costs. Among polymer materials, polymethylmethacrylate and polyetheretherketone are the most motivating, due to their biocompatibility, rigidity and toughness. Other biomaterials, with ecofriendly attributes, such as polycaprolactone and polylactic acid have been investigated, due to their microstructure that mimic the trabecular bone, encouraging vascularization and cell–cell communications. Taking into consideration that each material must be selected for specific clinical use, the main limitation remains the defects and the lack of vascularization, consequently porous synthetic substitutes could be an interesting way to support a faster and wider vascularization, with the aim to improve patient prognosis.

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Section: Discussion On Cranioplasty Materialsmentioning

confidence: 99%

State-of-Art of Standard and Innovative Materials Used in Cranioplasty

2021

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“…( G ) Patient’s head before cranioplasty indicating cranial defects in frontal regions. ( H ) Patient’s head after customized titanium implant, presenting improved aesthetic outcome due to restoration of calvarium contour [ 12 ].…”

Section: Figurementioning

confidence: 99%

“…The flexibility of design in 3DP is a massive advantage for the medical field as it allows for models to be customized for individual patients. In addition, there is low skill involved in the manufacturing process, meaning anyone can learn how to use this technology, making it applicable in the field of neuroscience [ 12 ]. Furthermore, 3DP allows for rapid prototyping and printing on demand, which could be ideal for scientific experiments.…”

Section: A Brief Introduction To Neurological Diseases and 3d Print T...mentioning

confidence: 99%

A Review of the Benefits 3D Printing Brings to Patients with Neurological Diseases

et al. 2023

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This interdisciplinary review focuses on how flexible three-dimensional printing (3DP) technology can aid patients with neurological diseases. It covers a wide variety of current and possible applications ranging from neurosurgery to customizable polypill along with a brief description of the various 3DP techniques. The article goes into detail about how 3DP technology can aid delicate neurosurgical planning and its consequent outcome for patients. It also covers areas such as how the 3DP model can be utilized in patient counseling along with designing specific implants involved in cranioplasty and customization of a specialized instrument such as 3DP optogenetic probes. Furthermore, the review includes how a 3DP nasal cast can contribute to the development of nose-to-brain drug delivery along with looking into how bioprinting could be used for regenerating nerves and how 3D-printed drugs could offer practical benefits to patients suffering from neurological diseases via polypill.

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“…[9][10][11][12][13][14][15] Primary cranioplasty techniques include autologous and alloplastic materials. 8,9,16,17 In the case of complex defects involving the calvarium with overlying soft tissue deficits, composite single-stage microvascular scalp reconstruction with concurrent cranioplasty may be indicated. [18][19][20][21][22][23] Clinically, with the advent of new cranioplasty materials and techniques there is an ever-increasing scope of the complexity of scalp and calvarial defects being managed.…”

mentioning

confidence: 99%

“…[18][19][20][21][22][23] Clinically, with the advent of new cranioplasty materials and techniques there is an ever-increasing scope of the complexity of scalp and calvarial defects being managed. 8,16,[23][24][25] However, there remains controversy in the literature regarding outcomes following cranioplasty with reported complication rates ranging from 6.8% to 34% and mortality rate up to 20%. [26][27][28][29][30][31] Furthermore, there is a paucity of literature on the outcomes and complications associated with single-stage composite reconstruction of scalp defects with concurrent cranioplasty, with current evidence limited to single-institution cohort and case studies.…”

mentioning

confidence: 99%

Trends and Outcomes of Cranioplasty Alone Versus Single-Stage Composite Scalp and Calvarial Reconstruction

Cormier

Lin

2021

Journal of Craniofacial Surgery

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Background: Cranioplasty is a critical intervention to restore the calvarium using autologous or alloplastic materials with singlestage composite scalp and calvarial reconstruction reserved for complex cases. This study aims to identify 30-day outcomes in scalp and calvarial reconstruction using the American College of Surgeons National Surgical Quality Improvement Program database. Methods: The authors conducted a retrospective analysis of the 2010 to 2018 American College of Surgeons National Surgical Quality Improvement Program database. Adult patients who underwent cranioplasty were identified using current procedural terminology coding and included by exposure type (autologous, alloplastic, composite, or other). Subjects with missing exposure or outcome data were excluded. Primary outcome was 30-day reoperation, whereas secondary outcomes were 30-day unplanned readmission and transfusion. Univariate analysis was completed to assess differences in demographics, comorbidities, and postoperative complications. Multivariable logistic regression was used to control for confounders. Results: In total, 1719 patients underwent cranioplasty (mean age 54.7 ± 15.3 years, 43.5% male), including 169(9.8%) autologous, 1303(75.8%) alloplastic, 32(1.9%) composite, and 215(12.5%) other procedures. Cranioplasty procedures were associated with 30-day complication and mortality rate of 16.5% and 2.4%, respectively. Composite cranioplasty was associated with decreased 30-day reoperation (adjusted odds ratios 0.11, 95% confidence interval 0.014-0.94, P = 0.044). There was no statistically significant difference in readmission between cranioplasty groups. Alloplastic cranioplasty was associated with decreased odds of postoperative transfusion (adjusted odds ratios 0.47, 95% confidence interval 0.27â 0.84, P= 0.01). Conclusions: Cranioplasty is an increasingly common procedure. Alloplastic cranioplasty is associated with decreased 30-day transfusion requirement, whereas single-stage composite reconstruction is a viable option and associated with decreased 30-day reoperation with no difference in readmission.

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Cranioplasty Using Customized 3-Dimensional–Printed Titanium Implants: An International Collaboration Effort to Improve Neurosurgical Care

Cited by 13 publications

References 25 publications

State-of-Art of Standard and Innovative Materials Used in Cranioplasty

State-of-Art of Standard and Innovative Materials Used in Cranioplasty

A Review of the Benefits 3D Printing Brings to Patients with Neurological Diseases

Trends and Outcomes of Cranioplasty Alone Versus Single-Stage Composite Scalp and Calvarial Reconstruction

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