This poster presentation demonstrates the 8 and 15 year follow-up of a cranioplasty reconstruction utilizing an alloplastic implant and bioabsorbable (PGA/PLA) pin fixation. The basic science of pin manufacture/absorption is presented.

Clinical History: The patient is a 67 year old male, initially seen in 1992. He had previously undergone the resection and ligation of an aneurysm of the right frontal/parietal area. He had done well postoperatively, but had been bothered by the gradual retrusion of the surgical bone flap. The defect, at that time, measured 11 cm. x 5 cm. Evaluation included a three dimensional CAT scan, and subsequent plaster moulage. the moulage was then used to construst an alloplastic implant. The implant was formulated of HTR polymer, made from polymethylacrylate (PMMA) macrobeads, coated and fused together with hydrophilic polymer, poly-2-hydroxyethylmethacrylate (PHEMA), after which the molded composite was coated with calcium hydroxide.

The patient was taken to the operating room in 1992, at which time the custom alloplastic was placed, using the previos craniotomy skin incision. Fixation of the implant was achieved with a series of bioabsorbable pins. Follow-up at 8 and 15 years is presented. The use of bioabsorbable zixation allows the ability of radiologic evaluation, including magnetic imaging and CAT scanning. Because of the lack of metallic fixation, no problems with radiologic scattering or distortion have been encountered. Further, use of the alloplastic implant precludes donor site morbidity.

This case , supported by 8 and 15 year follow demonstrates a safe and effective method of craniofacial reconstruction. The results are demonstrated both radiograpgically and photographically, and support the use of this method of reconstruction because of the well tolerated implants, with minimal morbidity/mortality.
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