Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty
Background Intraoperative hand-moulded cranioplasty and polymethylmethacrylate (PMMA) prostheses made from bone impressions are economical but the cosmetic results are less than satisfactory. Commercially available customized prostheses perform better but are prohibitively expensive. We evaluate the...
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| Veröffentlicht in: | Acta neurochirurgica 2022-03, Vol.164 (3), p.655-667 |
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| creator | Baldia, Manish Joseph, Mathew Sharma, Suryaprakash Kumar, Deva Retnam, Ashwin Koshy, Santosh Karuppusami, Reka |
| description | Background
Intraoperative hand-moulded cranioplasty and polymethylmethacrylate (PMMA) prostheses made from bone impressions are economical but the cosmetic results are less than satisfactory. Commercially available customized prostheses perform better but are prohibitively expensive. We evaluate the performance of a locally developed, low-cost customized PMMA cranioplasty prosthesis.
Objective
To compare the cosmetic outcome of 3 types of PMMA cranioplasty as well as with objective measurements on postoperative CT scans
Methods
This study includes 70 patients who underwent cranioplasty between March 2016 and June 2020. In this period, patients had their cranioplasty prostheses made by intra-operative hand moulding (HM), by using the removed bone as a template and making a bone impression (BI) or by 3D printing the prosthesis based on a CT scan. Cosmetic outcomes were assessed by the patient and the operating surgeon on an 8-point scale. The degree of measured anthropometric asymmetry was measured on a postoperative CT scan and correlated with the cosmetic outcome.
Results
Our locally produced 3D-printed cranioplasty prostheses showed a statistically better performance in
cosmetic score
s when compared to the HM and BI (
p
value < 0.001). CT anthropometric measurements significantly correlated with cosmetic outcome (
p
value 0.01)
Conclusion
Our 3D cranioplasty prostheses had better cosmetic outcomes than HM and BI prostheses, and our technique is able to produce them at 10% of the cost of the currently available commercial customized prostheses. |
| doi_str_mv | 10.1007/s00701-022-05121-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2624951679</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2637861927</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-d28833b4c254123185c4abfa12bc300300b7247e3c8faf5f0c0be36e916a84983</originalsourceid><addsrcrecordid>eNp9kUtv1TAQhS1ERR_wB1ggS2zYpPUrccIOXdGHVKmbsrYc3zE3VRIH26FKV_3pTHoLqCyQrPGM5jvHlg4h7zk75Yzps4SF8YIJUbCSC-xekSPWKBwbxV5jz3Bdiao-JMcp3eEktJJvyKEsOdMV10fkcTOnHIbuAbbUhZQL8B5c7n4CnUK_DJB3S79W6-LS2wzURTt2YeptystnalcV7juHzTDZ2KUw0vsu72jIO4i0D_fFakxXk7BNNPgXFm_Jgbd9gnfP9wn5dv71dnNZXN9cXG2-XBdO6jIXW1HXUrbKiVJxIXldOmVbb7lonWQMT6uF0iBd7a0vPXOsBVlBwytbq6aWJ-TT3neK4ccMKZuhSw763o4Q5mREJVRT8ko3iH78B70Lcxzxd0hJXVe8ERopsadcDClF8GaK3WDjYjgzaz5mn4_BfMxTPoah6MOz9dwOsP0j-R0IAnIPJFyN3yH-ffs_tr8APJidcQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2637861927</pqid></control><display><type>article</type><title>Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Baldia, Manish ; Joseph, Mathew ; Sharma, Suryaprakash ; Kumar, Deva ; Retnam, Ashwin ; Koshy, Santosh ; Karuppusami, Reka</creator><creatorcontrib>Baldia, Manish ; Joseph, Mathew ; Sharma, Suryaprakash ; Kumar, Deva ; Retnam, Ashwin ; Koshy, Santosh ; Karuppusami, Reka</creatorcontrib><description>Background
Intraoperative hand-moulded cranioplasty and polymethylmethacrylate (PMMA) prostheses made from bone impressions are economical but the cosmetic results are less than satisfactory. Commercially available customized prostheses perform better but are prohibitively expensive. We evaluate the performance of a locally developed, low-cost customized PMMA cranioplasty prosthesis.
Objective
To compare the cosmetic outcome of 3 types of PMMA cranioplasty as well as with objective measurements on postoperative CT scans
Methods
This study includes 70 patients who underwent cranioplasty between March 2016 and June 2020. In this period, patients had their cranioplasty prostheses made by intra-operative hand moulding (HM), by using the removed bone as a template and making a bone impression (BI) or by 3D printing the prosthesis based on a CT scan. Cosmetic outcomes were assessed by the patient and the operating surgeon on an 8-point scale. The degree of measured anthropometric asymmetry was measured on a postoperative CT scan and correlated with the cosmetic outcome.
Results
Our locally produced 3D-printed cranioplasty prostheses showed a statistically better performance in
cosmetic score
s when compared to the HM and BI (
p
value < 0.001). CT anthropometric measurements significantly correlated with cosmetic outcome (
p
value 0.01)
Conclusion
Our 3D cranioplasty prostheses had better cosmetic outcomes than HM and BI prostheses, and our technique is able to produce them at 10% of the cost of the currently available commercial customized prostheses.</description><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-022-05121-0</identifier><identifier>PMID: 35107617</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Brain trauma ; Computed tomography ; Cost-Benefit Analysis ; Humans ; Interventional Radiology ; Medical imaging ; Medicine ; Medicine & Public Health ; Minimally Invasive Surgery ; Neurology ; Neuroradiology ; Neurosurgery ; Original Article - Brain trauma ; Performance evaluation ; Polymethyl Methacrylate - therapeutic use ; Polymethylmethacrylate ; Prostheses ; Prostheses and Implants ; Prosthetics ; Reconstructive Surgical Procedures - methods ; Skull ; Skull - diagnostic imaging ; Skull - surgery ; Surgical Orthopedics</subject><ispartof>Acta neurochirurgica, 2022-03, Vol.164 (3), p.655-667</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2022</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-d28833b4c254123185c4abfa12bc300300b7247e3c8faf5f0c0be36e916a84983</citedby><cites>FETCH-LOGICAL-c375t-d28833b4c254123185c4abfa12bc300300b7247e3c8faf5f0c0be36e916a84983</cites><orcidid>0000-0001-8470-0589</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00701-022-05121-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00701-022-05121-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35107617$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baldia, Manish</creatorcontrib><creatorcontrib>Joseph, Mathew</creatorcontrib><creatorcontrib>Sharma, Suryaprakash</creatorcontrib><creatorcontrib>Kumar, Deva</creatorcontrib><creatorcontrib>Retnam, Ashwin</creatorcontrib><creatorcontrib>Koshy, Santosh</creatorcontrib><creatorcontrib>Karuppusami, Reka</creatorcontrib><title>Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><addtitle>Acta Neurochir (Wien)</addtitle><description>Background
Intraoperative hand-moulded cranioplasty and polymethylmethacrylate (PMMA) prostheses made from bone impressions are economical but the cosmetic results are less than satisfactory. Commercially available customized prostheses perform better but are prohibitively expensive. We evaluate the performance of a locally developed, low-cost customized PMMA cranioplasty prosthesis.
Objective
To compare the cosmetic outcome of 3 types of PMMA cranioplasty as well as with objective measurements on postoperative CT scans
Methods
This study includes 70 patients who underwent cranioplasty between March 2016 and June 2020. In this period, patients had their cranioplasty prostheses made by intra-operative hand moulding (HM), by using the removed bone as a template and making a bone impression (BI) or by 3D printing the prosthesis based on a CT scan. Cosmetic outcomes were assessed by the patient and the operating surgeon on an 8-point scale. The degree of measured anthropometric asymmetry was measured on a postoperative CT scan and correlated with the cosmetic outcome.
Results
Our locally produced 3D-printed cranioplasty prostheses showed a statistically better performance in
cosmetic score
s when compared to the HM and BI (
p
value < 0.001). CT anthropometric measurements significantly correlated with cosmetic outcome (
p
value 0.01)
Conclusion
Our 3D cranioplasty prostheses had better cosmetic outcomes than HM and BI prostheses, and our technique is able to produce them at 10% of the cost of the currently available commercial customized prostheses.</description><subject>Brain trauma</subject><subject>Computed tomography</subject><subject>Cost-Benefit Analysis</subject><subject>Humans</subject><subject>Interventional Radiology</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally Invasive Surgery</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Original Article - Brain trauma</subject><subject>Performance evaluation</subject><subject>Polymethyl Methacrylate - therapeutic use</subject><subject>Polymethylmethacrylate</subject><subject>Prostheses</subject><subject>Prostheses and Implants</subject><subject>Prosthetics</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Skull</subject><subject>Skull - diagnostic imaging</subject><subject>Skull - surgery</subject><subject>Surgical Orthopedics</subject><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtv1TAQhS1ERR_wB1ggS2zYpPUrccIOXdGHVKmbsrYc3zE3VRIH26FKV_3pTHoLqCyQrPGM5jvHlg4h7zk75Yzps4SF8YIJUbCSC-xekSPWKBwbxV5jz3Bdiao-JMcp3eEktJJvyKEsOdMV10fkcTOnHIbuAbbUhZQL8B5c7n4CnUK_DJB3S79W6-LS2wzURTt2YeptystnalcV7juHzTDZ2KUw0vsu72jIO4i0D_fFakxXk7BNNPgXFm_Jgbd9gnfP9wn5dv71dnNZXN9cXG2-XBdO6jIXW1HXUrbKiVJxIXldOmVbb7lonWQMT6uF0iBd7a0vPXOsBVlBwytbq6aWJ-TT3neK4ccMKZuhSw763o4Q5mREJVRT8ko3iH78B70Lcxzxd0hJXVe8ERopsadcDClF8GaK3WDjYjgzaz5mn4_BfMxTPoah6MOz9dwOsP0j-R0IAnIPJFyN3yH-ffs_tr8APJidcQ</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Baldia, Manish</creator><creator>Joseph, Mathew</creator><creator>Sharma, Suryaprakash</creator><creator>Kumar, Deva</creator><creator>Retnam, Ashwin</creator><creator>Koshy, Santosh</creator><creator>Karuppusami, Reka</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8470-0589</orcidid></search><sort><creationdate>20220301</creationdate><title>Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty</title><author>Baldia, Manish ; Joseph, Mathew ; Sharma, Suryaprakash ; Kumar, Deva ; Retnam, Ashwin ; Koshy, Santosh ; Karuppusami, Reka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-d28833b4c254123185c4abfa12bc300300b7247e3c8faf5f0c0be36e916a84983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Brain trauma</topic><topic>Computed tomography</topic><topic>Cost-Benefit Analysis</topic><topic>Humans</topic><topic>Interventional Radiology</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Minimally Invasive Surgery</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Original Article - Brain trauma</topic><topic>Performance evaluation</topic><topic>Polymethyl Methacrylate - therapeutic use</topic><topic>Polymethylmethacrylate</topic><topic>Prostheses</topic><topic>Prostheses and Implants</topic><topic>Prosthetics</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Skull</topic><topic>Skull - diagnostic imaging</topic><topic>Skull - surgery</topic><topic>Surgical Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baldia, Manish</creatorcontrib><creatorcontrib>Joseph, Mathew</creatorcontrib><creatorcontrib>Sharma, Suryaprakash</creatorcontrib><creatorcontrib>Kumar, Deva</creatorcontrib><creatorcontrib>Retnam, Ashwin</creatorcontrib><creatorcontrib>Koshy, Santosh</creatorcontrib><creatorcontrib>Karuppusami, Reka</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baldia, Manish</au><au>Joseph, Mathew</au><au>Sharma, Suryaprakash</au><au>Kumar, Deva</au><au>Retnam, Ashwin</au><au>Koshy, Santosh</au><au>Karuppusami, Reka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><addtitle>Acta Neurochir (Wien)</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>164</volume><issue>3</issue><spage>655</spage><epage>667</epage><pages>655-667</pages><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>Background
Intraoperative hand-moulded cranioplasty and polymethylmethacrylate (PMMA) prostheses made from bone impressions are economical but the cosmetic results are less than satisfactory. Commercially available customized prostheses perform better but are prohibitively expensive. We evaluate the performance of a locally developed, low-cost customized PMMA cranioplasty prosthesis.
Objective
To compare the cosmetic outcome of 3 types of PMMA cranioplasty as well as with objective measurements on postoperative CT scans
Methods
This study includes 70 patients who underwent cranioplasty between March 2016 and June 2020. In this period, patients had their cranioplasty prostheses made by intra-operative hand moulding (HM), by using the removed bone as a template and making a bone impression (BI) or by 3D printing the prosthesis based on a CT scan. Cosmetic outcomes were assessed by the patient and the operating surgeon on an 8-point scale. The degree of measured anthropometric asymmetry was measured on a postoperative CT scan and correlated with the cosmetic outcome.
Results
Our locally produced 3D-printed cranioplasty prostheses showed a statistically better performance in
cosmetic score
s when compared to the HM and BI (
p
value < 0.001). CT anthropometric measurements significantly correlated with cosmetic outcome (
p
value 0.01)
Conclusion
Our 3D cranioplasty prostheses had better cosmetic outcomes than HM and BI prostheses, and our technique is able to produce them at 10% of the cost of the currently available commercial customized prostheses.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>35107617</pmid><doi>10.1007/s00701-022-05121-0</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-8470-0589</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0001-6268 |
| ispartof | Acta neurochirurgica, 2022-03, Vol.164 (3), p.655-667 |
| issn | 0001-6268 0942-0940 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Brain trauma Computed tomography Cost-Benefit Analysis Humans Interventional Radiology Medical imaging Medicine Medicine & Public Health Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Original Article - Brain trauma Performance evaluation Polymethyl Methacrylate - therapeutic use Polymethylmethacrylate Prostheses Prostheses and Implants Prosthetics Reconstructive Surgical Procedures - methods Skull Skull - diagnostic imaging Skull - surgery Surgical Orthopedics |
| title | Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty |
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