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Is Polymethylmethacrylate Reliable and Practical in Full-Thickness Cranial Defect Reconstructions?

Akan, Mithat MD; Karaca, Mustafa MD; Eker, Güniz MD; Karanfil, Hüseyin MD; Aköz, Tayfun MD

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1236-1239
doi: 10.1097/SCS.0b013e31821c0f34
Original Articles

Objective: The study aimed to evaluate the success of polymethylmethacrylate cranioplasty combined with various soft tissue coverage techniques in repairing full-thickness cranial defects, to compare our results with similar studies published before, and to describe a simple method of implant premolding.

Methods: A total of 17 patients who had cranial defects due to various etiologies underwent polymethylmethacrylate cranioplasty. In 10 patients, the implant premolding method was applied. The soft tissue coverage was obtained by primary closure, local flaps, or free flaps.

Results: The follow-up period ranged from 36 hours to 5 years. Only 1 implant became exposed among the 17 patients. One patient died 36 hours after the surgery because of myocardial infarction. The remaining 15 patients had no early or late postoperative complications. Good contour restoration and stable reconstruction of the calvarial defects were realized, and a successful combination of various soft tissue coverage techniques was achieved.

Conclusions: We concluded that polymethylmethacrylate was a cheap and durable material, useful in full-thickness calvarial defect reconstructions. It can be combined with any soft tissue coverage techniques except skin grafting. In most cases, the simple premolding methods are useful for both defect matching and preventing tissue damage due to exothermic reaction of the material.

From the Department of Plastic and Reconstructive Surgery, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.

Received October 19, 2010.

Accepted for publication November 20, 2010.

Address correspondence and reprint requests to Mustafa Karaca, MD, Esentepe mah. Milangaz cad. Unluer sit. B blok D:8, Kartal, Istanbul, Turkey; E-mail:

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD