Titanium Mesh versus Autologous Bone Graft Cranioplasty

Objective: To compare the efficacy of titanium mesh to autologous bone grafting in cranioplasty and assessing complications like seroma and abscess formations and subjective measures of pain. Study Design: Comparative cross-sectional study Place and Duration of Study: Neurosurgery Department, Combined Military Hospital, Rawalpindi Pakistan from Aug 2017 to Dec 2018. Methodology: Twenty patients (Women=12, Men=8) were randomly assigned to Titanium Mesh (TM) group and 20 patients (Women=7, Men=13) to Autologous Bone Graft (ABG) group. All were subjected to cranioplasty using Titenium Mesh and Autologous Bone Graft procedures to assess cranial seroma and abscess formation and pain. Results: Comparison of pain on day 3 showed 7(35%) patients in titenium mesh group experienced pain compared to 14(70%) patients in the autologous bone graft group, which was statistically significant (p<0.001). Similarly, a comparison on day 7, revealed that pain in the titenium mesh group reduced to 5(25%) patients compared to 11(55%) patients in the autologous bone graft group, which again was statistically significant (p<0.001). Four(20%) patients in titenium mesh group and 7(35%) patients in autologous bone graft group developed seroma on day 3 and the difference was significant (p<0.001). Two(10%) patients in titenium mesh group and 5(25%) patients in autologous bone graft group developed abscess, which was significantly different (p<0.001). Conclusion: Cranioplasty using titenium mesh is better than autologous bone graft because complications like seroma, abscess and pain are attenuated in surgical cohorts.