With the technological developments, three-dimensional (3D) printers are being used more in the medical field and this technology is being used in neurosurgery by producing personalized implants.
Cranioplasty refers to the surgical repair of a defect or deformity in the skull with the help of an autologous, biological, or non-biological material. It is roughly the process of replacing a bone fragment that is missing in the skull for some reason or surgically placing a different material that is cosmetically and functionally suitable for the defect in the defect area.
Although the protection of the brain from external damage and cosmetic correction are the main objectives of cranioplasty, it is also observed that the incidence of epilepsy decreases in patients after cranioplasty, the emotional state of patients improves, and their social performance increases. At the same time, one of the benefits of cranioplasty is to normalize the intra-cavity pressure and dynamics by getting rid of the direct effect of atmospheric air pressure on the brain by performing cranioplasty. Thanks to this, it has been shown that increases in cerebral blood flow, accelerating cellular metabolism and faster healing of existing brain damage are provided. In the rare trepanation syndrome, treatment is also possible with cranioplasty and it has been reported in the literature that there is an improvement in the neurological status of patients after the procedure.
Cranioplasty is performed to close the bone defect in patients who have undergone decompressive craniectomy for various reasons. Apart from decompressive craniectomy, calvarium lesions requiring cranioplasty are neoplastic, inflammatory, and congenital lesions. Other reported rare indications are craniectomy for osteomyelitis, congenital defects, metabolic bone diseases, and enlarged skull fractures.
Among the indications for cranioplasty, “trepanation syndrome”, which occurs a few months after the formation of the defect, is reported to be observed especially in cases with large bone defects and includes psychic and neurological findings such as headache, restlessness, behavioral changes, sound and vibration intolerance, motivational disorder, concentration disorder, anxiety, motor deficit, aphasia, and epileptic seizure.
Source: Rifat Saygın ALTINAĞ, MD Thesis of Specialization
