title: Prefabricated patient-matched cranial implants for reconstruction of large skull defects.
abstract: Cranial defects can be caused by injury, infection, or tumor invasion. Large defects should be reconstructed to protect the brain and normalize the cerebral hemodynamics. The conventional method is to cover the defect with bone cement. Custom-made implants designed for the individual patient are now available. We report our experience with one such product in patients with large cranial defects (>7.6 cm in diameter). A CT scan with 2 mm slices and a three-dimensional reconstruction were obtained from the patient. This information was dispatched to the company and used as a template to form the implant. The cranial implant was received within four weeks. From 2005 to 2010, custom-made cranial implants were used in 13 patients with large cranial defects. In 10 of the 13 patients, secondary deep infection was the cause of the cranial defect. All the implants fitted well or very well to the defect. No infections were seen after implantation; however, one patient was reoperated on for an epidural hematoma. A custom-made cranial implant is considerably more expensive than an implant made of bone cement, but ensures that the defect is optimally covered. The use of custom-made implants is straightforward and timesaving, and they provide an excellent medical and cosmetic result.
authors: Department of Neurosurgery, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors: Jarle
authors: J
authors: Sundseth
authors: Jon
authors: J
authors: Berg-Johnsen
keywords: 3-D CT; cranial implant; custom made
references: Acta Neurochir Suppl. 2005;93:127-9
references: 15986741
references: J Neurosurg Pediatr. 2009 Oct;4(4):378-82
references: 19795971
references: Neurosurg Focus. 2009 Jun;26(6):E9
references: 19485722
references: J Craniofac Surg. 2003 Nov;14(6):819-32
references: 14600623
references: Neurosurg Focus. 2009 Jun;26(6):E10
references: 19485714
references: Neurochirurgie. 2011 Feb;57(1):21-7
references: 20870257
references: Acta Neurochir Suppl. 2008;102:15-20
references: 19388280
references: J Neurosurg. 1994 Sep;81(3):483-6
references: 8057161
references: Cell Tissue Bank. 2007;8(3):243-6
references: 17273898
references: Neurosurgery. 2003 Mar;52(3):591-6; discussion 595-6
references: 12590683
references: J Plast Reconstr Aesthet Surg. 2010 Sep;63(9):1479-84
references: 19766072
references: Neurosurg Focus. 2008;24(6):E10
references: 18518740
references: J Neurosurg. 2000 Jul;93(1):53-61
references: 10883905
references: J Neurosurg. 2006 Oct;105(4):640-4
references: 17044572
references: Plast Reconstr Surg. 2002 Mar;109(3):864-71
references: 11884798
references: J Clin Neurosci. 1996 Apr;3(2):149-55
references: 18638858
references: J Trauma. 2010 Jan;68(1):183-7; discussion 187
references: 20065773
references: J Neurosurg. 1967 Oct;27(4):376-8
references: 6054741
references: J Clin Neurosci. 2009 Jan;16(1):56-63
references: 19046734
references: Neurosurgery. 1997 Nov;41(5):1073-9; discussion 1079-81
references: 9361061
references: Br J Neurosurg. 1999 Dec;13(6):576-80
references: 10715726
references: Br J Neurosurg. 2005 Apr;19(2):155-62
references: 16120519
references: J Trauma. 1970 Mar;10(3):249-54
references: 5435543
references: ANZ J Surg. 2011 Mar;81(3):137-41
references: 21342384
references: J Clin Neurosci. 2004 Jun;11(5):486-9
references: 15177389
references: Acta Neurochir (Wien). 1985;78(3-4):81-90
references: 3911746
references: J Neurosurg. 2008 Oct;109(4):729-34
references: 18826362