Abstract
Trauma to the cranium and fronto-orbito-temporal region can result in devastating defects. Comminuted frontal-orbital bone fractures may preclude reconstruction with plates and screws. Cranial defects can also result due to the loss of bone flap from prior neurosurgical intervention such as evacuation of traumatic intracranial hematoma. Fronto-orbital defects present functional, esthetic, and psychologic consequences. Reconstruction of these defects is necessary to provide protection to the underlying brain and globe, restoring form and symmetry to the cranial vault. Presently, the most commonly used materials include autologous bone grafts, titanium mesh, methylmethacrylate, polyethylene sheets, and hydroxyapatite cements. Each material has its advantages and disadvantages, and the search for an ideal calvarial replacement continues. With the advancement of computed 3D imaging and 3D rapid prototyping, computer-assisted designed and computer-assisted manufactured (CAD-CAM) prostheses are gaining popularity. 1 Toth B.A. Ellis D.S. Stewart W.B. Computer-designed prostheses for orbitocranial reconstruction. Plast Reconstr Surg. 1988; 81: 315 Crossref PubMed Scopus (93) Google Scholar , 2 Schmitz H.J. Tolxdorff T. Honsbrok J. et al. 3D-based computer assisted manufacturing of individual alloplastic implants for cranial and maxillofacial osteoplasties. in: Lemke H.U. Rhodes M.L. Jaffe C.C. Computer-Assisted Radiology CAR '89. Springer, Berlin1989: p 390 Crossref Google Scholar , 3 Epker B.N. Stella J.P. Reconstruction of frontal and frontal nasal deformities with prefabricated custom implants. J Oral Maxillofac Surg. 1989; 47: 1272 Abstract Full Text PDF PubMed Scopus (11) Google Scholar , 4 Joffe J.M. McDermott P.J.C. Linney A.D. et al. Computer generated titanium cranioplasty: Report of a new technique for repairing skull defects. Br J Neurosurg. 1992; 6: 343 Crossref PubMed Scopus (65) Google Scholar , 5 Ono I. Gunji H. Suda K. et al. Method for preparing an exact size model using helical volume scan computed tomography. Plast Reconstr Surg. 1994; 93: 1363 Crossref PubMed Scopus (61) Google Scholar , 6 D'Urso P.S. Earwaker W.J. Barker T.M. et al. Custom cranioplasty using stereolithography and acrylic. Br J Plast Surg. 2000; 53: 200 Abstract Full Text PDF PubMed Scopus (231) Google Scholar , 7 Eppley B.L. Kilgo M. Colemann J.J. Cranial reconstruction with computer-generated hard-tissue replacement patient matched implants: Indications, surgical technique, and long term follow-up. Plast Reconstr Surg. 2002; 109: 864 Crossref PubMed Scopus (74) Google Scholar , 8 Frodel Jr, J.L. Computer-designed implants for fronto-orbital defect reconstruction. Facial Plast Surg. 2008; 24: 22 Crossref PubMed Scopus (25) Google Scholar
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