Cranioplasty: Surgical Research

Abstract

Background: Cranioplasty involves the repair of a cranial defect or deformation for cosmetic reasons, as well as long-term protection of the brain from the external environment. This work aims to evaluate and compare the efficacy, advantages and limitations of different materials used in cranioplasty. 
 Methods: Prospective study of twenty-five patients who underwent cranioplasty for a skull bone defect by using different materials from March 2018 to March 2020. 
 Results: The study included 13 males and 12 females. The defect was post-traumatic in 11 patient neoplastic in 13 patients and 1 patient was after decompressive craniectomy for malignant ischemia .When the defect was less than 80 cm² bone cement was used in 54.5%. When the defect was ≥ 80 cm² titanium mesh was used in 71.4 % of those cases. 72.0% of the patients (18 of 25) reported excellent cosmetic results, 24% (6 of 25) good, 4.0% (1 of 25) poor results. 
 Conclusion: When the original bone flap is not available for cranioplasty titanium mesh is suitable for the large calverial bone defects. it is strong but hard to shape while bone cement is more suitable for small defects near the skull base as it is easy to shape but weak. Medpore and hydroxyapetite powder are better for pediatric defects as they don't hinder bone growth. Prefabricated bone flaps are effective but expensive and can't be used if cranioplasty is planned in the same operation.