title: Is polymethylmethacrylate reliable and practical in full-thickness cranial defect reconstructions?
abstract: OBJECTIVE
  The study aimed to evaluate the success of polymethylmethacrylate cranioplasty combined with various soft tissue coverage techniques in repairing full-thickness cranial defects, to compare our results with similar studies published before, and to describe a simple method of implant premolding.
  
  
  METHODS
  A total of 17 patients who had cranial defects due to various etiologies underwent polymethylmethacrylate cranioplasty. In 10 patients, the implant premolding method was applied. The soft tissue coverage was obtained by primary closure, local flaps, or free flaps.
  
  
  RESULTS
  The follow-up period ranged from 36 hours to 5 years. Only 1 implant became exposed among the 17 patients. One patient died 36 hours after the surgery because of myocardial infarction. The remaining 15 patients had no early or late postoperative complications. Good contour restoration and stable reconstruction of the calvarial defects were realized, and a successful combination of various soft tissue coverage techniques was achieved.
  
  
  CONCLUSIONS
  We concluded that polymethylmethacrylate was a cheap and durable material, useful in full-thickness calvarial defect reconstructions. It can be combined with any soft tissue coverage techniques except skin grafting. In most cases, the simple premolding methods are useful for both defect matching and preventing tissue damage due to exothermic reaction of the material.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mithat
authors.initials: M
authors.lastname: Akan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karaca
authors.forename: Güniz
authors.initials: G
authors.lastname: Eker
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Karanfil
authors.forename: Tayfun
authors.initials: T
authors.lastname: Aköz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012886:Skull / Q000601:surgery*; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000209:etiology; D015626:Tissue Expansion / Q000379:methods; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D019904:Polymethyl Methacrylate