Current Concepts in Cranioplasty: Indications, Materials, Surgical Techniques, and Complications

Objective:  This study evaluates the clinical outcomes, materials used, and complications associated with cranioplasty thus providing a comprehensive analysis based on patient’s data. Materials and Methods:  This retrospective observational study was conducted at Ali Institute of Neurosciences, Irfan General Hospital, Peshawar from November 2023 to December 2024. A total of 55 patients who underwent cranioplasty were included in the study. The study analyzed patient demographics, indications, material selection, surgical techniques, and postoperative complications. Results:  The most common indication for cranioplasty was post-traumatic defects (63.6%), followed by decompressive craniectomy (25.4%), tumor resection (5.5%), and infection-related bone flap removal (5.5%). The materials used included polyetheretherketone (PEEK) (34.5%), bone cement (30.9%)  titanium mesh (18.2%), and acrylic mesh (16.4%). Postoperative infections occurred in 7% of patients and were successfully managed with antibiotics or revision surgery. No cases of implant rejection or resorption were observed. Conclusion:  Cranioplasty plays a crucial role in restoring cranial integrity improving neurological and aesthetic outcomes. Advances in biomaterials particularly PEEK, have enhanced procedural success in our study. While the surgery remains essential for functional and cosmetic rehabilitation optimizing material selection and infection prevention strategies can further improve patient outcomes.