{"id":"6b170a66-d460-42b9-a248-7aab96647817","slug":"comparison-of-two-different-titanium-cranioplasty-methods-custom-made-titanium-prostheses-versus-precurved-titanium-mesh","title":"Comparison of two different titanium cranioplasty methods: Custom-made titanium prostheses versus precurved titanium mesh","authors":["Domenico Policicchio","Gina Casu","Giosuè Dipellegrini","Artan Doda","Giampiero Muggianu","Riccardo Boccaletti"],"abstract":"Background: The aim of this study was to compare the results of two different titanium cranioplasties for reconstructing skull defects: standard precurved mesh versus custom-made prostheses. Methods: Retrospective analysis of 23 patients submitted to titanium cranioplasty between January 2014 and January 2019. Ten patients underwent delayed cranioplasty using custom-made prostheses; and 13 patients were treated using precurved titanium mesh (ten delayed cranioplasties, and three single-stage resection- reconstructions). Demographic, clinical, and radiological data were recorded. Results and complications of the two methods were compared, including duration of surgery, cosmetic results (visual analog scale for cosmesis [VASC]), and costs of the implants. Results: Complications: one epidural hematoma in the custom-made group, one delayed failure in precurved group due to wound dehiscence with mesh exposure. There were no infections in either group. All custom-made prostheses perfectly fitted on the defect; eight of 13 precurved mesh prostheses incompletely covered the defect. Custom-made cranioplasty obtained better cosmetic results (average VASC 94 vs. 68), shorter surgical time (141min vs. 186min), and -fewer screws was needed to fix the prostheses in place (6 vs. 15). However, satisfactory results were obtained using precurved mesh in cases of small defects and in single-stage reconstruction. Precurved mesh was found to be cheaper (€1,500 vs. €5,500). Conclusion: Custom-made cranioplasty obtained better results and we would suggest that this should be a first choice, particularly for young patients with a large cranial defect. Precurved mesh was cheaper and useful for single-stage resection-reconstruction. Depending on the individual conditions, both prostheses have their place in cranioplasty therapies.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/6b170a66-d460-42b9-a248-7aab96647817/featured/hero-1781563397820.png","publishDate":"2020-06-13T00:00:00.000Z","doi":"10.25259/SNI_35_2020","categories":["General Neurosurgery","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/06/10077/SNI-11-148.pdf"}