• Haewon Roh, Junwon Kim, Jang Hun Kim, Kyuha Chong, Won Ki Yoon, Taek-Hyun Kwon, and Jong Hyun Kim.
• Department of Neurosurgery, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Focused Training Center for Trauma, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
• World Neurosurg. 2019 Mar 1; 123: e39-e44.

ObjectiveTo report outcomes of cranioplasty (CP) with a customized three-dimensional (3D) titanium mesh plate and identify the relationship between various clinical variables and complications after CP.MethodsTwenty patients who underwent surgery with customized 3D titanium mesh plates and had follow-up for >6 months from January 2015 to December 2017 were enrolled. Complications related to CP were retrospectively reviewed. Patients were divided into 2 groups (no complication group and complication group), and clinical variables related to complications were compared between the 2 groups. Correlation analysis was performed to identify the clinical variable significantly correlated with complications after CP with a customized 3D titanium mesh plate.ResultsOf 20 patients, 11 developed complications, including extrusion, intracranial infection, severe operative site pain, and wound dehiscence. Among the clinical variables, only the presence of a ventriculoperitoneal shunt was significantly correlated with the overall complication rate (odds ratio = 18.66; 95% confidence interval, 1.56-222.92; P = 0.021).ConclusionsA customized 3D titanium mesh plate is associated with a lower risk of intracranial infection, but the rate of postoperative complications, mainly cosmetic problems, such as forehead mesh extrusion and dehiscence, was high at 55%. A ventriculoperitoneal shunt was significantly correlated with the overall complication rate after CP with a customized 3D titanium mesh plate.Copyright © 2018 Elsevier Inc. All rights reserved.

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