Skull bone defects reconstruction with custom-made titanium graft shaped with electron beam melting technology: Preliminary experience in a series of ten patients

Background: Cranioplasty represents a challenge in neurosurgery. Its goal is not only plastic reconstruction of the skull but also to restore and preserve cranial function, to improve cerebral hemodynamics, and to provide mechanical protection of the neural structures. The ideal material for the reconstructive procedures and the surgical timing are still controversial. Many alloplastic materials are available for performing cranioplasty and among these, titanium still represents a widely proven and accepted choice. Methods: The aim of our study was to present our preliminary experience with a “custom-made” cranioplasty, using electron beam melting (EBM) technology, in a series of ten patients. EBM is a new sintering method for shaping titanium powder directly in three-dimensional (3D) implants. Findings: To the best of our knowledge this is the first report of a skull reconstruction performed by this technique. In a 1-year follow-up no postoperative complications have been observed and good clinical and esthetic outcomes were achieved. Conclusion: Costs higher than those for other types of titanium mesh, a longer production process, and the greater expertise needed for this technique are compensated by the achievement of most complex skull reconstructions with a shorter operative time.