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Cranioplasty Enhanced by Three-Dimensional Printing: Custom-Made Three-Dimensional-Printed Titanium Implants for Skull Defects.

 Eun-Kyung Park  ;  Jun-Young Lim  ;  In-Sik Yun  ;  Ju-Seong Kim  ;  Su-Heon Woo  ;  Dong-Seok Kim  ;  Kyu-Won Shim 
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.27(4) : 943-949, 2016 
Journal Title
Issue Date
Adolescent ; Adult ; Biocompatible Materials* ; Brain Diseases/surgery* ; Child ; Computer-Aided Design ; Craniocerebral Trauma/surgery* ; Craniotomy* ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Models, Anatomic ; Postoperative Complications/surgery ; Printing, Three-Dimensional* ; Reconstructive Surgical Procedures/methods* ; Reoperation ; Skull/surgery* ; Titanium* ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult
3D printing ; cranioplasty ; custom-design ; skull defect ; titanium alloy implant
The authors studied to demonstrate the efficacy of custom-made three-dimensional (3D)-printed titanium implants for reconstructing skull defects. From 2013 to 2015, 21 patients (8-62 years old, mean = 28.6-year old; 11 females and 10 males) with skull defects were treated. Total disease duration ranged from 6 to 168 months (mean = 33.6 months). The size of skull defects ranged from 84 × 104 to 154 × 193 mm. Custom-made implants were manufactured by Medyssey Co, Ltd (Jecheon, South Korea) using 3D computed tomography data, Mimics software, and an electron beam melting machine. The team reviewed several different designs and simulated surgery using a 3D skull model. During the operation, the implant was fit to the defect without dead space. Operation times ranged from 85 to 180 minutes (mean = 115.7 minutes). Operative sites healed without any complications except for 1 patient who had red swelling with exudation at the skin defect, which was a skin infection and defect at the center of the scalp flap reoccurring since the initial head injury. This patient underwent reoperation for skin defect revision and replacement of the implant. Twenty-one patients were followed for 6 to 24 months (mean = 14.1 months). The patients were satisfied and had no recurrent wound problems. Head computed tomography after operation showed good fixation of titanium implants and satisfactory skull-shape symmetry. For the reconstruction of skull defects, the use of autologous bone grafts has been the treatment of choice. However, bone use depends on availability, defect size, and donor morbidity. As 3D printing techniques are further advanced, it is becoming possible to manufacture custom-made 3D titanium implants for skull reconstruction.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Kim, Ju Seong(김주성)
Park, Eun Kyung(박은경)
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Yun, In Sik(윤인식) ORCID logo https://orcid.org/0000-0003-1103-7047
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