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KMID : 1001920120520060541
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Journal of Korean Neurosurgical Society
2012 Volume.52 No. 6 p.541 ~ p.546
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Customized Cranioplasty Implants Using Three-Dimensional Printers and Polymethyl-Methacrylate Casting
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Kim Bum-Joon
Hong Ki-Sun
Park Kyung-Jae
Park Dong-Hyuk
Chung Yong-Gu
Kang Shin-Hyuk
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Abstract
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Objective: The prefabrication of customized cranioplastic implants has been introduced to overcome the difficulties of intra-operative implant molding. The authors present a new technique, which consists of the prefabrication of implant molds using three-dimensional (3D) printers and polymethyl-methacrylate (PMMA) casting.
Methods: A total of 16 patients with large skull defects (>100 cm2) underwent cranioplasty between November 2009 and April 2011. For unilateral cranial defects, 3D images of the skull were obtained from preoperative axial 1-mm spiral computed tomography (CT) scans. The image of the implant was generated by a digital subtraction mirror-imaging process using the normal side of the cranium as a model. For bilateral cranial defects, precraniectomy routine spiral CT scan data were merged with postcraniectomy 3D CT images following a smoothing process. Prefabrication of the mold was performed by the 3D printer. Intraoperatively, the PMMA implant was created with the prefabricated mold, and fit into the cranial defect.
Results: The median operation time was 184.36±26.07 minutes. Postoperative CT scans showed excellent restoration of the symmetrical contours and curvature of the cranium in all cases. The median follow-up period was 23 months (range, 14-28 months). Postoperative infection was developed in one case (6.2%) who had an open wound defect previously.
Conclusion: Customized cranioplasty PMMA implants using 3D printer may be a useful technique for the reconstruction of various cranial defects.
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KEYWORD
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Decompressive craniectomy, Reconstructive surgical procedure, Computer-aided design, Polymethyl-methacrylate
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