Use of Titanium Mesh vs. Prolene Mesh with Polymethylmethacrylate Bone Cement in the Repair of Skull Vault Defects: A Comparative Study

Abstract Background: The medical procedure known as cranioplasty is utilized for the purpose of reconstructing the skull's anatomy and repairing any defects present in the skull. Achieving optimal skull reconstruction poses a challenge for neurosur-geons, and the most effective strategy to attain the best outcome is still a subject of discussion. Aim of Study: To present the different indications, benefits, possible techniques, and methods of surgical repair of cranial vault defects. In addition, 20 cases will be presented comparing two methods of surgical repair of these defects. Patients and Methods: The data collected from the 20 cases that were operated upon during the study were analyzed as 10 cases operated upon by prolene mesh with bone cement cranioplasty and 10 cases operated upon by titanium mesh cranioplasty, and the results were concluded and evaluated. Results: We discussed the characteristics of many materials used in cranioplasty and set standards for the characteristics of an ideal cranioplasty material in general, then compared the outcomes of two of the most important materials used nowadays. In addition, we have included 20 cases with cranial defects that required surgical repair, caused by different etiologies, mostly post-traumatic and post-tumor resection, and demonstrated the results. These cases have been operated upon by placing titanium mesh in 10 cases and prolene mesh with a bone cement implant in another 10 cases. When com-paring both materials, we found that there was no significant difference in cosmetic outcome. However, prolene mesh with bone cement implants was found to restore contouring more easily than titanium mesh, as prolene mesh is more flexible and bone cement is easier to mold. As regards cost, prolene mesh with bone cement is cheaper than titanium mesh. As regards complications, there was one case of prolene mesh with bone cement that had a wound infection, and we believe this was most probably due to the poor hygiene of the patient, so this obstacle can be avoided in future cases. Conclusion: We discovered no significant difference in aesthetic result between the two types of reconstruction, however prolene mesh with bone cement implants restored contouring more easily than titanium mesh because it is more flexible and simpler to shape. Titanium mesh costs more than bone cement-coated prolene mesh.