Additive Manufacturing and Reverse Engineering in Cranioplasty: A Personalized Approach to Minimize Skin Flap Complications

Abstract

Cranioplasty is a procedure performed to repair defects in the human skull bone by surgically reconstructing the shape and function of the cranium. Several complications, both intraoperative and postoperative, can affect the procedure’s outcome (e.g., inaccuracies of the reconstructed shape, infections, ulcer, necrosis). Although the design of additive manufactured implants in a preoperative stage has improved the general quality of cranioplasties, potential complications remain significant, especially in the presence of critical skin tissue conditions. In this paper, an innovative procedure to improve the chances of a positive outcome when facing critical conditions in a cranioplasty is described. The proposed approach relies on a structured planning phase articulated in a series of digital analyses and physical simulations performed on personalized medical devices that guide the surgeon in defining surgical cuts and designing the implant. The ultimate goal is to improve the chances of a positive outcome and a fast recovery for the patient. The procedure, described in extenso in the paper, was positively tested on a cranioplasty case study, which presented high risk factors.