Archives of Medicine and Health Review

Journal of the Nigerian Medical Association, FCT

Reconstruction of Skull Defects using Titanium Cranioplasty: a single institutional experience

Pg: 47-61


Authors: Ugwuanyi CU*, Anigbo AA***, Salawu Morayo M**, Igbokwe KK***, Onobun D***, Mordi CO***, OkpataCI**, Ayogu OM**
KEYWORDS: Cranial bone defects, cranioplasty, autologous bone, titanium plate, computer-assisted design and manufacture


Abstract

Introduction – Cranioplasty becomes necessary for the reconstruction of defects on the calvarium. These defects result from various etiologies including iatrogenic. Situations arise when the traditional autologous bone flap and/or methyl methacrylate plate becomes either unavailable or unsuitable for this purpose. Computer-assisted designed and manufactured (CAD/CAM) customized titanium plate became a fallback option in a few of such cases and our local experience with this option is hereby shared in this case series.

Aims and Objectives – To report experiences gathered from three cases of  CAD/CAM customized titanium  plate cranioplasty in our local practice

Methodology – a retrospective review of three patients who underwent CAD/CAM customized titanium cranioplasty was conducted. This review detailed the whole clinical process, through pre-op planning, operative procedures and post-op challenges.

Results – Three patients, presented to our neurosurgery clinic with cranial defects as a consequence of emergency decompressive craniectomy in the past for malignant cerebral edema in two cases of stroke and one case of acute subdural empyema. Computer-assisted design and manufacture (CAD/CAM) of customized titanium plate was conducted amidst huge logistic challenges but cranioplasty was successfully conducted and the cosmetic finish was satisfactory to all patients.

Conclusion – This case series shows that custom-made patient-specific allogenous materials such as titanium cranioplasty have become a viable alternative when other commonly applied options as outlined above become inappropriate, unsuitable or unacceptable.