A Hybrid Workflow for Customised Cranial Prosthesis: A Case Report

Rationale: Reconstruction of large cranial defects requires an accurate, cost-effective and patient-specific approach, particularly in resource-constrained settings. Patient Concerns: A 44-year-old female with a post-craniectomy cranial defect presented with altered mental status indicative of neurological impairment. Diagnosis: Computed tomography (CT) confirmed an 8.5 cm × 6.5 cm frontoparieto-temporal defect. Treatment: A hybrid workflow combined digital and conventional methods. CT Digital Imaging and Communications in Medicine data were used to fabricate a three-dimensional (3D)-printed skull model. A wax pattern was adapted over it and processed in a customised cranial flask using heat-cured polymethyl methacrylate (PMMA), followed by surgical implantation. Outcomes: Prosthesis fit was assessed intraoperatively, with satisfactory adaptation to the defect margins. At 12 months, the prosthesis remained stable with satisfactory healing and no complications. Take-away Lessons: The proposed hybrid workflow combines the planning advantages of digital 3D printing with the practicality of conventional PMMA processing using a customised cranial flask, providing a cost-effective approach for patient-specific cranial reconstruction in resource-constrained settings.