Cranioplasty: Comparison Between Utilizing Titanium Mesh, Prefabricated Polymethyl methacrylate and Autograft Bone.

Abstract

Background: A Cranioplasty is the term for any operation in which a defect of the skull bone is repaired. A traumatic injury is often the reason , but there are other reasons including previous tumour surgery or surgery for some forms of stroke. Aim Of Study: The aim of this study is to compare between the using of titanium mish, polymethylmethacrylate (PMMA), and Autograft bone in cranioplasty. Material And Method: In our study 20 patients , 12 males (60%) and 8 females (40%), ages ranged for 15-45 years, were subjected to cranioplasty that were performed to achieve morphological and functional rehabilitation of the cranial vault using ;polymethylmethacrylate ,titanium mish and autograft bone. Our patients underwent elective delayed cranioplasty in Al-Ramadi Teaching Hospital during the period from December 2006 to December 2010.Results: Although the use of titanium may cause artifact on computed tomography (CT scans) ,which can limit follow –up imaging studies, but our study proved that the use of titanium is remarkable. Prefabricated PMMA prostheses are effective for cranioplasty, so reduced surgical time, reduced surgical blood loss and technical simplicity. The infection rate associated with use of prefabricated PMMA prostheses is lower than that for autograft bone flaps. All patients were highly satisfied with the cosmetic appearance ,Cranioplasty was carried out with no major complication except in two cases.Conclusion: The use of titanium mesh for cranioplasty is a good alternative in spite of the disadvantages, causing an artifact on CT and magnetic resonance imaging (MRI) , and it's expensiveness. Prefabricated PMMA prostheses are effective for cranioplasty in respect to reduced surgical time, reduced surgical blood loss and technical simplicity. The infection rate associated with use of prefabricated PMMA prostheses is lower than that for autograft bone flaps.