title: Feasibility of the custom-made titanium cranioplasty CRANIOTOP(®).
abstract: BACKGROUND
  With decompressive craniectomy for ischemic stroke, traumatic brain injury, and skull-infiltrating tumors, the need for cranioplasty has increased. Different materials for custom-made cranioplasties have been evaluated, but a gold standard could not yet be established. We report our experience with the new custom-made titanium CRANIOTOP(®)cranioplasty (CL Instruments, Germany).
  
  
  METHODS
  A total of 50 consecutive patients received a CRANIOTOP cranioplasty within a 2 year interval. We reviewed the charts for time between initial surgery and cranioplasty, indication, complications, operative time, and cosmetic outcome. Postoperative imaging (computed tomography [CT] scan n = 48, magnetic resonance imaging (MRI) n = 5) was screened for fitting accuracy and for hemorrhages.
  
  
  RESULTS
  The most common indication for craniectomy were diffuse edema due to traumatic brain injury (n = 17, 34%) and ischemic stroke (n = 12, 24%). All patients were satisfied with the cosmetic result. In the postoperative CT scan accurate fitting was confirmed in all patients, the postoperative MRI was free of artifacts. Surgical revision was necessary in five patients because of empyema (n = 2), wound exposure (n = 2), and one cerebrospinal fluid fistula. Thus, the surgical morbidity was 10%.
  
  
  CONCLUSIONS
  With due consideration of the limitations of this retrospective study, we feel the present data allow concluding that the custom-made titanium cranioplasty CRANIOTOP(®)is safe and feasible.
authors: Department of Neurosurgery, University Medical Center, Regensburg, Germany.
authors: Julius
authors: J
authors: Höhne
authors: Alexander
authors: A
authors: Brawanski
authors: Holger G
authors: HG
authors: Gassner
authors: Karl-Michael
authors: KM
authors: Schebesch
keywords: CL Instruments; CRANIOTOP; craniectomy; titanium cranioplasty
references: World Neurosurg. 2013 Jan;79(1):124-30
references: 22079278
references: J Craniomaxillofac Surg. 2013 Dec;41(8):803-7
references: 23434238
references: Plast Reconstr Surg. 1998 Aug;102(2):300-8
references: 9703063
references: Br J Neurosurg. 1994;8(4):409-14
references: 7811404
references: J Neurosci Rural Pract. 2011 Jul;2(2):162-7
references: 21897681
references: J Craniofac Surg. 2009 Sep;20(5):1512-8
references: 19816288
references: Minim Invasive Ther Allied Technol. 2010 Apr;19(2):110-21
references: 20166839
references: Br J Neurosurg. 2012 Dec;26(6):832-7
references: 22702389
references: J Craniomaxillofac Surg. 2012 Apr;40(3):e65-70
references: 21640597
references: J Neurosurg. 2007 Nov;107(5):905-12
references: 17977259
references: Br J Neurosurg. 2000 Dec;14(6):555-9
references: 11272035
references: J Craniofac Surg. 2003 Mar;14(2):144-53
references: 12621283
references: Neurosurg Focus. 2009 Jun;26(6):E9
references: 19485722
references: Br J Plast Surg. 1990 Sep;43(5):528-35
references: 2224346
references: Acta Neurochir (Wien). 2012 May;154(5):919-26
references: 22402877
references: Orbit. 2009;28(6):371-6
references: 19929662
references: Can J Neurol Sci. 2011 Jan;38(1):59-64
references: 21156431
references: Neurosurg Focus. 2009 Jun;26(6):E10
references: 19485714
references: Acta Neurochir (Wien). 2006 May;148(5):535-40; discussion 540
references: 16467959
references: Neurosurgery. 1997 Mar;40(3):588-603
references: 9055300
references: Lancet Neurol. 2007 Mar;6(3):215-22
references: 17303527
references: Plast Reconstr Surg. 2005 Nov;116(6):1726-41
references: 16267439
references: Surg Neurol. 1997 Mar;47(3):238-41
references: 9068693
references: Neurosurgery. 2013 Feb;72(2):248-56; discussion 256
references: 23149967
references: Clin Neurol Neurosurg. 2010 Apr;112(3):177-82
references: 20056312