Evaluation of locally manufactured patient-specific custom made implants for cranial defects using a silicone mould

  • Adriaan J Vlok Stellenbosch University
  • Sachindrin Naidoo Stellenbosch University
  • Ameya S Kamat Stellenbosch University
  • Deon Lamprecht Stellenbosch University
Keywords: trauma, craniectomy, cranioplasty


Background: Cranial vault defects can pose a significant problem for neurosurgeons where autologous bone is no longer available for cranioplasty. Numerous materials exist to create implants which include polymethyl methacrylate (PMMA) and titanium. A technique using 3 dimensional CT scan reconstruction of a cranial defect and creating a silicon mould which can be autoclaved in theatre to create a PMMA implant was developed.

Objectives: The aim of this study is to evaluate the efficacy, cosmetic result, safety and cost-effectiveness of this procedure and compare this to existing techniques.

Methods: An ambispective study was performed in patients requiring cranioplasty with a custom made implant. Patients were assessed for risk factors and cosmetic outcome, surgical technique was described and complications and cost compared to existing literature between 2010 and 2016.

Results: Thirty retrospective and 30 consecutive prospective patients were recruited into the study. Overall sepsis rate was 8.3%. All septic cases had superficial sepsis of which 2 grafts were removed due to cerebrospinal fluid leakage resulting in wound breakdown. A 100% accurate implant to defect ratio was achieved leading to a high satisfaction rate. Average cost was 5 times cheaper than the closest market related product.

Conclusion: Patient specific moulds using PMMA to create custom implants are safe, have excellent cosmetic results and are a very cost effective option to manage cranial defects. Accurate planning strategies for large craniotomies, where bone will potentially be discarded, add to surgical effectiveness and cost-saving to the patient.

How to Cite
Vlok, A., Naidoo, S., Kamat, A., & Lamprecht, D. (2018). Evaluation of locally manufactured patient-specific custom made implants for cranial defects using a silicone mould. South African Journal of Surgery, 56(3), 38-42. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2521