Reduction Cranioplasty in Cases of Hydrocephalic Macrocephaly: Pearls and Pitfalls of Computer-Assisted Surgery

Reduction cranioplasty may be indicated to address functional or cosmetic sequelae of hydrocephalic macrocephaly. With the advent of CAD/CAM digital workflow, surgeons can design and fabricate craniotomy guides, templates, and models that allow for precise cranial reconstruction. Although there are several advantages of virtual planning, pre-determined surgical plans may limit intraoperative flexibility, requiring surgeons to troubleshoot errors in pre-operative planning or model design. The purpose of this report is to present a series of cases demonstrating our institution's technique for single-stage reduction cranioplasty using a CAD/CAM workflow. This report will highlight the benefits and challenges associated with a contemporary digital workflow for reduction cranioplasty.