Silicone rubber mould cast polyethylmethacrylate-hydroxyapatite plate used for repairing a large skull defect.
BACKGROUND
Reconstruction of the cranial vault is performed for various reasons and precise repair of the defect is important. A modified method of cranioplasty is presented using three-dimensional (3D) models and polyethylmethacrylate mixed with hydroxyapatite, cast in a silicone rubber mould.


METHODS
A large custom made cranial implant was produced using data acquired from 3D computer tomography, rapid prototyping and cast in a silicone rubber mould. This plate was then applied to a 53 year-old man who had undergone a decompressive fronto-parieto-temporo-occipital craniotomy. The bone flap had been lost due to infection. The cranioplasty was performed at 1 year after the initial operation.


RESULTS
The cranial plate fitted precisely into the defect and needed no correction at the time of surgery. The stability of the reconstruction plate was increased by the presence of thin margins allowed by silicone rubber elasticity. No complications occurred and the final functional and aesthetic results were good.


CONCLUSIONS
The use of 3D imaging and rapid prototyping allow precise repair of large skull defects, with good aesthetic and functional results. At the same time, silicone rubber moulds permit the production of very thin details needed not only for cosmetic reasons but for reconstruction plate stability as well.
Rotaru
Horatiu
H
Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. hrotaru@rdslink.ro
Baciut
Mihaela
M
Stan
Horatiu
H
Bran
Simion
S
Chezan
Horea
H
Iosif
Alexandru
A
Tomescu
Mircea
M
Kim
Seong-Gon
SG
Rotaru
Alexandru
A
Baciut
Grigore
G
D001860:Bone Plates; D001929:Brain Edema / Q000601:surgery; D003399:Craniotomy / Q000295:instrumentation*; D017886:Durapatite; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008689:Methacrylates; D008875:Middle Aged; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012826:Silicone Elastomers; D014057:Tomography, X-Ray Computed
D008689:Methacrylates; D012826:Silicone Elastomers; D017886:Durapatite