Introduction: Low-cost 3D desktop printing has the potential to revolutionize the socioeconomic paradigm for medical implants. Previously, custom implants were only available from commercial vendors at great expense. Here we show the utility of 3D desktop printing to create an affordable custom mold of a cranial implant and defect. These models can be used to rapidly shape and size titanium mesh resulting in a cosmetically pleasing result with significant savings in operative sculpting time.
Methods: Computed tomography (CT) scans of the head obtained before and after hemicraniectomy were uploaded into Osirix software to convert the DICOM images to a 3D model and then edited in MeshLab. Makerbot Desktop was used to convert the files into a printer-compatible format. A Flashforge Creator Pro 3D desktop printer was used to print the cranial models using acrylonitrile butadiene styrene (ABS). Preoperatively, the cranial implant model was used to mold 1.0mm thick titanium mesh into the appropriate shape. The model of the cranial defect was used to size the mesh and test the fit. The mesh was sterilized and made available intraoperatively. The final fit of the implant was confirmed and it was secured in place spanning the cranial defect without the need for additional contour shaping.
Results: A 3D desktop printer was used to create a plastic mold of a cranial implant and cranial defect. These were used to rapidly contour and size a piece of titanium mesh. The mesh was successfully implanted without the need for intraoperative re-shaping resulting in an excellent cosmetic result. The estimated cost savings compared to commercially available custom implants is between $7,000 to $15,000 per case depending on the company and product used.
Conclusions: Significant cost savings can be achieved with 3D desktop printing technology when performing large defect cranioplasty on patients where the original bone is not available for reimplantation.
Patient Care: Decrease costs and improve the quality of inexpensive titanium mesh cranioplasty implantation for large cranioplasty defects where the patient's own bone is unavailable.
Learning Objectives: Identify an example of how low-cost 3D printing can be used to decrease healthcare costs.
Recognize that patients who cannot afford high-cost commercial custom cranial implants may benefit from custom cranial implant models being created with desktop 3D printers as a way to obtain better cosmetic results with titanium mesh