Hydroxyapatite ceramic implants were used in the reconstruction of very lar
ge and complex-form cranial bone defects in nine patients. The bone defects
were the result of craniectomy after infections and other complications su
ch as severe brain edema, after neurosurgery, and as a result of trauma, su
bdural hemorrhage, and surgery for brain tumor. The size, shape, and curvat
ure of the hydroxyapatite ceramic implants were determined based on high-pr
ecision, full-scale models fabricated through a laser lithographic molding
method by using computed tomographic data. The use of this method allowed t
he fabrication of hydroxyapatite ceramic implants of shapes that accurately
matched the area of bone defect, allowing for a minimum of adjustment duri
ng the operation even with a complex-form implantation. Not only were good
cranial contour reconstructed and aesthetically satisfactory results obtain
ed in the cases treated by incorporating this series of techniques, but neu
rologic conditions present in some cases were also improved to some extent.
The postoperative course has been steady for all nine patients, with no bl
ood transfusions required during or after the operations and no implants re
quiring removal because of infection or other postoperative complications.
The average length of postoperative hospitalization for the nine cases was
11.7 days, remarkably short considering the clinical conditions.