A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome

The use of computerized three dimensional imaging and automated milling of models to produce accurate titanium plates for the reconstruction of cranio facial defects is described. A total of 148 patients have had extensive cal varial defects repaired using this (computer aided design and manufacture) technique developed in our unit. Of these, 141 were repaired secondarily (d elayed cranioplasty), whilst seven were repaired immediately following cran iectomy (single stage cranioplasty). All cases were assessed for accuracy o f fit, restoration of natural skull contour and aesthetics. Seventy-two pat ients were reviewed after 1 year to determine the effect on adverse preoper ative symptoms. Of the plates 97% had an excellent or good intraoperative f it. The modal insertion time was only 15 minutes. Postoperatively 98% resul ted in the restoration of natural skull shape and symmetry. After 1 year, 8 2% of patients had complete resolution or diminution in severity of the adv erse symptoms. A staphylococcus infection necessitated the temporary remova l of one plate.