Cranioplasty: autologous bone graft vs. titanium mesh

Background: Cranioplasty (CP) is a neurosurgical procedure performed after decompressive craniectomy using autologous bone graft or various artificial materials. Objective: To determine differences in complications between patients who underwent CP using an autologous bone flap versus titanium mesh and to identify significant risk factors for post-CP complications. Study design: Comparative cross-sectional study. Methods: A total of 38 patients, 29 males (76.4%) and 9 females (23.6%), were included in this study. All patients underwent cranioplasty with titanium mesh or autologous bone graft. Results: The results were compared between autografts and titanium implants. Autologous bone graft was used in 76.3% of the patients and titanium implant was used in 23.7%. Different complications occurred in 5.26% of the patients in both groups, 2.63% in the autologous group and 2.63% in the titanium mesh group respectively. Infection occurred in the surgical site in 5.26% of the patients in both groups (similar). Cranioplasty infection occurred in 2.63% of the patients who underwent autologous transplantation. One patient developed a hematoma in both groups. One patient underwent autologous bone graft removal, and one patient underwent mesh removal. Practical implication: Titanium mesh cranioplasty is an essential procedure for junior neurosurgeons to learn and achieve good results, shorten hospital stays, and save hospital resources. Conclusion: Titanium mesh cranioplasty has similar complications to autologous bone cranioplasty.