title: In Situ Cranioplasty Technique for Immediate Calvarial Reconstruction to Optimize Cosmesis.
abstract: OBJECTIVE
  One of the goals of calvarial reconstruction after craniectomy is optimization of cosmesis. A simple technique for intraoperative generation of an implant based on the patient's native skull contour for immediate skull reconstruction after craniectomy is described.
  
  
  METHODS
  In this technique, a titanium mesh is molded to the contour of the skull in situ and temporarily secured to the calvarium before the craniectomy. After the definitive portion of the procedure, the implant is resecured using the predrilled holes in the skull.
  
  
  RESULTS
  In situ titanium cranioplasties are easily contoured to the patient's native skull before, and resecured after, craniectomy. Postoperative cosmesis is excellent.
  
  
  CONCLUSIONS
  In selected cases, this technique for in situ cranioplasty before craniectomy generates an implant that mimics the patient's calvarium and results in excellent cosmetic outcomes.
authors.affiliation: Departments of Neurosurgery, Otolaryngology-Head and Neck Surgery, and Oncology, Johns Hopkins Hospital, Baltimore, Maryland, USA. Electronic address: ggallia1@jhmi.edu.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Gallia
mesh_terms: D000505:Alopecia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012886:Skull / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013526:Surgical Mesh; D014025:Titanium; D014057:Tomography, X-Ray Computed
chemical_list: D014025:Titanium
keywords: Cosmesis; Craniectomy; Cranioplasty; Skull reconstruction; Titanium