Silicone rubber mould cast polyethylmethacrylate-hydroxyapatite plate used for repairing a large skull defect.

Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Journal of Cranio-Maxillofacial Surgery (Impact Factor: 1.61). 07/2006; 34(4):242-6. DOI: 10.1016/j.jcms.2006.01.005
Source: PubMed

ABSTRACT Reconstruction of the cranial vault is performed for various reasons and precise repair of the defect is important. A modified method of cranioplasty is presented using three-dimensional (3D) models and polyethylmethacrylate mixed with hydroxyapatite, cast in a silicone rubber mould.
A large custom made cranial implant was produced using data acquired from 3D computer tomography, rapid prototyping and cast in a silicone rubber mould. This plate was then applied to a 53 year-old man who had undergone a decompressive fronto-parieto-temporo-occipital craniotomy. The bone flap had been lost due to infection. The cranioplasty was performed at 1 year after the initial operation.
The cranial plate fitted precisely into the defect and needed no correction at the time of surgery. The stability of the reconstruction plate was increased by the presence of thin margins allowed by silicone rubber elasticity. No complications occurred and the final functional and aesthetic results were good.
The use of 3D imaging and rapid prototyping allow precise repair of large skull defects, with good aesthetic and functional results. At the same time, silicone rubber moulds permit the production of very thin details needed not only for cosmetic reasons but for reconstruction plate stability as well.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In the last decades, the technical field of additive layered manufacturing (ALM) has offered aid in medical reconstruction procedures in order to help surgeons reconstruct physical faults and anomalies of their patients. Using a combination of Computer Assisted Design (CAD), high medical skills and latest ALM technologies, it is now possible to help patients with birth defects or those suffering from craniofacial injuries of variable severities, retain aesthetic and functional properties of their bodies. Combined with traditional CT scanning techniques rapid technologies (prototyping and tooling) can be used as instruments for better (three-dimensional) visualization, simulation of procedures and treatment of patients. They also improve the overall performances of medical and nursing staff thus influencing the quality of medical service. Using a combination of Computer Assisted Design (CAD), high medical skills and latest rapid prototyping and manufacturing technologies, it is now possible to help patients with craniofacial deformities as birth defects, orthognathic deformities, deformities after malignancy treatment or the consequences of craniofacial injuries of variable severities, resulting in both aesthetic and functional alterations. This paper presents some clinical cases, carried out in cooperation of Faculty of Mechanical Engineering in Maribor and both University Clinical Centres in Slovenia, where virtual models have been used for surgical preparations and RP models for manufacturing of implants.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Methacrylate is a valuable tool to the neurosurgeon, even though it is currently being replaced by custom bone. During cranioplasty in the absence of custom bone, which is preformed based on the patients imaging, one has to make a cast to cover the cranial defect with or without the use of a mould. A good artificial skull outline is necessary for prevention of implant extrusion and acceptable cosmetic outcome. Using the patients head as a mould is a simple, cheap, and useful technique. An incision is made, and either a craniectomy or an attempt at skull elevation or separation of the scalp from dura is done based on the indication for the cranioplasty. The methacrylate monomer is mixed with its solvent. It is placed in between a sliced glove and then thinned out. Several layers of drapes are placed on the patients head, the acrylate which is in between the gloves is then placed on the drapes. As soon as it starts setting and the required shape obtained, it is removed and place on the sterile tray. It is then anchored and the wound closed. This technique produces good cosmetic outcome. However, the head must be properly protected from the risk of burns from the exothermic reaction. The technique is described in a 40-year-old driver who had a compound depressed skull fracture. He had a methylmethacrylate cranioplasty in the 9(th) week post trauma after allowing for wound healing. We recommend that this technique may be used in centers where custom bone is either too expensive or not available during cranioplasty in order to obtain a good outcome.
    Journal of neurosciences in rural practice. 01/2013; 4(4):471-474.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Inappropriate treatment of fractures of the frontal sinus can lead to serious complications. These fractures are often associated with soft tissue injuries and loss of bony structures. This case report shows the use of methyl methacrylate frontal prosthesis to treat a sequel of frontal sinus fracture; surgical options are discusses and one-year follow-up is present to show stability and good cosmetic result.
    International journal of burns and trauma. 01/2013; 3(4):225-231.

Full-text (2 Sources)

Available from
May 30, 2014