A Single Standard Polyvinyl Chloride 3D Skull Model to Create the Polymethyl Methacrylate Cranioplasty Flap: A Novel and Low-Cost Technique

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Background Although, cranioplasty is a commonly performed neurosurgical procedure worldwide, the cost of available cranioplasty implants is a major issue in a low-income country like India. The aims of this study were to introduce a novel and low-cost technique using a single standard three-dimensional (3D) skull model to guide the polymethyl methacrylate (PMMA) cranioplasty flap production and to evaluate the functional and cosmetic outcomes.

Methods We retrospectively evaluated 47 cases of PMMA cranioplasty in the period from February 2019 to June 2022. A single standard 3D skull model was used to make the PMMA cranioplasty flaps. The overall cost of this PMMA implant was compared with that of other available cranioplasty implants. The functional and cosmetic outcomes were evaluated postoperatively.

Results The mean age of our patients was 37.17 ± 13.83 years and the age range was 17 to 63 years. The primary cause of surgery was trauma in the majority of cases (n = 31, 65.96%). The mean operative time was 78.55 ± 19.82 minutes. The cosmetic results were very satisfying in 46 of 47 (97.87%) patients and moderately satisfying in 1 (2.12%) patient. Overall, there were three (6.38%) complications.

Conclusion Our technique provides excellent functional and cosmetic outcomes. The overall surgical cost of these PMMA implants was lower than that of the other available cranioplasty implants. This technique is currently the most cost-effective option for cranioplasty.

Keywords cranioplasty - 3D skull model - PMMA - low cost - novel technique - excellent - outcomes Authors' Contributions

H.P.P. contributed to study conception and design, data collection, analysis and interpretation of results, and manuscript preparation. D.K.S. contributed to study conception and design, analysis and interpretation of results, and manuscript preparation.

Publication History

Received: 29 August 2023

Accepted: 17 January 2024

Article published online:
15 April 2024

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