title: Cranioplasty using presurgically fabricated presterilised polymethyl methacrylate plate by a simple, cost-effective technique on patients with and without original bone flap: study on 29 patients.
abstract: OBJECTIVE
  The purpose of the study was to assess the clinical effectiveness of presurgically fabricated pre-sterilized polymethyl methacrylate (PMMA) plate as a cranioplasty material.
  
  
  METHODS
  The study group consisted of 29 patients with skull defect following decompressive craniectomy. Some patients had their original bone flap preserved and some were without it. In either group pre-sterilized prefabricated PMMA plate was used. On each visit, patients were clinically assessed; CT scans were taken in immediate follow up period but if needed more films were taken in subsequent follow ups. Post-op complications that include infection, post-op hematoma, chronic pain, aesthetic, biocompatibility, post-op dimensional changes of prosthesis were evaluated.
  
  
  RESULTS
  Mean follow up was 7 1/2 months. Five patients developed swelling and pain in the subsequent follow ups. One patient was treated conservatively with antibiotics. Tapping was performed in couple of patients. Surgical evacuation of hematoma was performed in one patient. Of the five infected plates, one demanded removal from the patient. One complained of chronic pain. Post-op follow up assessed clinically and by CT scan confirmed good aesthetic result, biocompatibility and dimensional stability of prosthesis.
  
  
  CONCLUSIONS
  The result of this study support the view that the use of prefabricated pre-sterilized PMMA plate as cranioplasty material is a simple, reliable, convenient way that brings acceptable function and aesthetics to patients who underwent decompressive craniectomy, in an inexpensive way.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kovai Medical Center and Hospital Ltd, Coimbatore, 641 014 Tamil Nadu India.
authors.forename: G M
authors.initials: GM
authors.lastname: Sharavanan
authors.affiliation: Department of Neurosurgery, Kovai Medical Center and Hospital Ltd, Coimbatore, 641 014 Tamil Nadu India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Jayabalan
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kovai Medical Center and Hospital Ltd, Coimbatore, 641 014 Tamil Nadu India.
authors.forename: K
authors.initials: K
authors.lastname: Rajasukumaran
authors.affiliation: Department of Epidemiology, Kovai Medical Center and Hospital Ltd, Coimbatore, 641 014 Tamil Nadu India.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Veerasekar
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kovai Medical Center and Hospital Ltd, Coimbatore, 641 014 Tamil Nadu India.
authors.forename: G
authors.initials: G
authors.lastname: Sathya
keywords: Alginate impression material; Compression molding technique; Decompressive craniectomy; Polymethyl methacrylate plate