{"id":"797f05c0-5c3a-41aa-bb64-4379324721e0","slug":"cranioplasty-with-polymethylmethacrylate-prostheses-fabricated-by-hand-using-original-bone-flaps-technical-note-and-surgical-outcomes","title":"Cranioplasty with polymethylmethacrylate prostheses fabricated by hand using original bone flaps: Technical note and surgical outcomes","authors":["Enrique Caro-Osorio","Rafael De la Garza-Ramos","Sergio R. Martínez-Sánchez","Félix Olazarán-Salinas"],"abstract":"Background: Decompressive craniectomies (DC) mandate future cranioplasties, accounting for the large array of biomaterials for this purpose. Polymethylmethacrylate (PMMA) is a very reliable thermoplastic that can be prefabricated or even molded intraoperatively to create an adequate prosthesis. Preformed PMMA implants made by hand have been superseded by newer 3-D printed implants, but this is accompanied by higher costs and timing issues, apart from having limited availability in developing and third-world countries. Methods: A total of 26 patients were operated over a span of 11 years. A total of 26 custom hand-made PMMA prostheses were fabricated using original bone flaps with the aid of a prosthodontist, in a process that took approximately 70 minutes for each implant. The result was an exact duplication of the patient's bone flap. Results: Of the 26 patients who underwent cranioplasty, the majority of patients were males, with a mean age of 39.2 years and traumatic brain injury as main indication for DC. After a mean interval of 2.4 months, all 26 patients underwent a cranioplasty and prosthesis placement. Only two patients (7.6%) suffered from direct cranioplasty-related complications after a median follow-up of 10.4 months. Median Glasgow Outcome Scale scores improved significantly from 3 to 4 after cranioplasty (P = 0.008). Conclusion: Prefabrication of custom PMMA prostheses by hand when original bone flaps are available is an excellent alternative to newer 3-D printing techniques, because it is relatively cheaper, less time consuming, and offers excellent results in terms of anatomical reconstruction and improvement of neurological function in long-term follow-ups.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/797f05c0-5c3a-41aa-bb64-4379324721e0/featured/hero-1782421020287.png","publishDate":"2013-10-08T00:00:00.000Z","doi":"10.4103/2152-7806.119535","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/797f05c0-5c3a-41aa-bb64-4379324721e0/pdf"}