4.8 Review

Next-generation personalized cranioplasty treatment

期刊

ACTA BIOMATERIALIA
卷 154, 期 -, 页码 63-82

出版社

ELSEVIER SCI LTD
DOI: 10.1016/j.actbio.2022.10.030

关键词

Cranioplasty; Biomaterials; Patient -specific implant; Automatic implant design

资金

  1. Bioengineering and Biodesign Initiative
  2. Department of Biotechnology, Government of India
  3. Abdul Kalam National Innovation Fellowship
  4. Indian National Academy of Engineering

向作者/读者索取更多资源

Decompressive craniectomy (DC) is commonly used to treat various brain disorders, while cranioplasty surgery restores cranial symmetry and cosmetic outcomes. The manufacturing of patient-specific implants has shifted towards biomolecules and cellular-based methods. Despite advancements in 3D printing and image processing, the clinical procedure is time-consuming and costly. Therefore, automated implant fabrication using data-driven methods can accelerate the design and manufacturing of patient-specific cranial implants, providing predictable clinical outcomes.
Decompressive craniectomy (DC) is a surgical procedure, that is followed by cranioplasty surgery. DC is usually performed to treat patients with traumatic brain injury, intracranial hemorrhage, cerebral infarction, brain edema, skull fractures, etc. In many published clinical case studies and systematic reviews, cranioplasty surgery is reported to restore cranial symmetry with good cosmetic outcomes and neurophysiologically relevant functional outcomes in hundreds of patients. In this review article, we present a number of key issues related to the manufacturing of patient-specific implants, clinical complications, cosmetic outcomes, and newer alternative therapies. While discussing alternative therapeutic treatments for cranioplasty, biomolecules and cellular-based approaches have been emphasized. The current clinical practices in the restoration of cranial defects involve 3D printing to produce patient-specific prefabricated cranial implants, that provide better cosmetic outcomes. Regardless of the advancements in image processing and 3D printing, the complete clinical procedure is time-consuming and requires significant costs. To reduce manual intervention and to address unmet clinical demands, it has been highlighted that automated implant fabrication by data-driven methods can accelerate the design and manufacturing of patient-specific cranial implants. The data-driven approaches, encompassing artificial intelligence (machine learning/deep learning) and E-platforms, such as publicly accessible clinical databases will lead to the development of the next generation of patient-specific cranial implants, which can provide predictable clinical outcomes.

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