Cost-effective 3D reconstruction of skull defects

Abstract

Cranial defects following decompressive craniectomy or tumour resection can result in major cosmetic, protective, and neurological deficits, including the “syndrome of the trephined”. While patient-specific PEEK and titanium implants offer excellent anatomical and functional results, their high-cost limits accessibility in many healthcare systems. This study describes a cost-effective cranioplasty technique that uses in-house 3D-printed skull models or templates to pre-contour standard titanium mesh implants. We report three representative cases of large cranial defects secondary to tumour resection, complex infection with decompressive craniectomy, and severe traumatic brain injury. In each case, preoperative CT data were used to generate a patient-specific 3D model, which guided precise shaping of the implant and restoration of the native cranial curvature. This workflow combines the affordability and availability of conventional materials with the accuracy of computer-aided planning, minimises intraoperative modelling time, and reduces the need for expensive industrial patient-specific implants. Our early experience suggests that 3D-assisted contouring of standard implants is a robust and accessible strategy for restoring cranial integrity and improving cosmetic outcomes in resource-constrained settings.