• Hussam Metwali, Mohamed Hassanin, and Tamer Ibrahim.
• Department of Neurosurgery, Kliniken Nordoberpfalz AG, Weiden, Germany. Electronic address: drhussamm@yahoo.com.
• World Neurosurg. 2021 Apr 1; 148: 110-114.

ObjectiveIn our technical note, we have presented a technique of cranioplasty for large skull defects.MethodsA thin-slice computed tomography scan is performed. A model of the skull is constructed using a desktop 3-dimensional printer from the computed tomography scan. The skull model is filled with towels of soft cotton and inserted in a sterile thin plastic bag. The implant is molded intraoperatively on the skull model under sterile conditions. After surgical exposure of the skull defect, the implant is inserted and fixed using miniplates and miniscrews. The technique was used in 6 patients and described in 2 representative cases.ResultsThe required time and cost are significantly lower than those for other techniques used for preoperative manufacture of implants. No technique-related complications occurred. The radiological and cosmetic results were satisfactory. In the present case series, no early or delayed complications occurred.ConclusionThe presented technique is simple, safe, and time- and cost-effective. The technique and results are reproducible.Copyright © 2021 Elsevier Inc. All rights reserved.

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