Management of cranial and craniofacial bone defects with prefabricated individual titanium implants: follow-up and evaluation of 166 patients with 169 titanium implants from 1994 to 2000

Objective The TICC (Tomography, Image processing, CAD, CAM) processing chain developed at the Ruhr-University Bochum in Germany has already been established since several years for the reconstruction of large pre-existing posttraumatic skull defects with individual prefabricated implants made of pure titanium. So far, more than 500 titanium implants have been inserted with great success at more than 60 clinical centres worldwide. The aim of our study was to evaluate all implants inserted between 1994 and 2000. Materials and Methods The study describes the clinical experience with 166 patients receiving 169 skull implants between 1994 and 2000. All 169 implants were measured and categorized in the CAD system in terms of size and anatomical localization. The surgical and radiological reports of the patients were evaluated. Sixty patients operated at the university hospital in Bochum and nearby were clinically reviewed describing scars, position of the implants and cosmetic results. Questionnaires of 131 patients were analyzed regarding the postoperative quality of life distinctly. Results The study shows constantly good to excellent results intraoperatively as well as postoperatively regarding complications, fit of the implants and the clinical follow-up. In particular the enquiry of the patients shows that titanium skull implants improve quality of life. Conclusion High precision and easy handling as well as a low complication rate and the high contentedness of the patients make the individual titanium skull implants valuable for cranioplasty, especially in complicated applications with very large defects, multiple previous operations and additional irradiations. Even in these difficult cases predictable results are possible.