AIM: This work aims to present the different indication, benefits, possible complications and methods used for fixation of methyl methacrylate in cranioplasty. Also, 50 cases will be presented demonstrating the different aetiologies of the defects, and the different techniques used for fixation of methyl methacrylate in cranioplasty. METHODS: This investigation included a prospective study to be carried out on 50 patients with cranial defects of different aetiologies, sites and sizes to be operated upon in Cairo University Hospitals starting from August 2016 to April 2017.RESULTS: The principal aims of cranioplasty in this study are to restore aesthetic contour and to provide cerebral protection. However, it has been noted that a great improvement occurs in cerebral blood flow and cerebral perfusion after cranioplasty. CONCLUSION: Ball and socket technique appear to be a simple, safe economic and efficient method for fixation of cranioplasty flap. The high incidence of development of postoperative seroma suggests the necessity of-of a subgaleal drain placement for 48 hours.

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