Customized Titanium Implants for Cranial Fibrous Dysplasia: A Personalized Surgical Approach and Single-Center Experience

BACKGROUND AND OBJECTIVES: The optimal treatment for cranial fibrous dysplasia (CFD) is surgical resection and reconstruction, enhanced by computer-assisted techniques and custom-made implants. This study describes the surgical treatment of CFD using preoperative computer-assisted planning, a custom-made template, and titanium implants for reconstruction. METHODS: Over a 12-year period, 33 patients (19 males, 14 females) with monostotic CFD underwent surgical treatment involving tumor resection and reconstruction with custom titanium implants. The mean age was 38 years (range: 19-63). Preoperative computed tomography (CT) with 0.5-mm slices was used for precise planning. A computer-assisted template was created to determine tumor margins and minimize complications. Based on this, patient-specific titanium implants were designed and manufactured. During surgery, the template guided tumor removal and the implants were secured with miniscrews. Postoperative CT scans were performed for follow-up. RESULTS: Histopathological examination confirmed the diagnosis in all cases. The bone defect that occurred after resection during surgery was reconstructed using a patient-specific, 3-dimensional–printed titanium cranioplasty implant. No complications occurred during or after the surgery. Complete tumor removal and satisfactory cosmetic results were verified on postoperative CT scans. The mean follow-up duration was 108 months (range: 7-149 months). CONCLUSION: Computer-aided design and manufacturing of customized titanium implants provide a safe and effective approach for CFD reconstruction. This method allows precise resection, excellent cosmetic outcomes, and low complication rates, making it a reliable technique for cranioplasty.