A review of case series of various types of cranioplasty following decompressive craniectomy in a tertiary care centre

Abstract Background Cranioplasty following decompressive craniectomy (DC) is a critical procedure that restores cranial integrity, improves cerebral physiology and enhances cosmetic and psychological outcomes. The choice of material and timing of reconstruction can significantly impact postoperative recovery and complication rates. Objective To analyse the postoperative complications and cosmetic outcomes of different cranioplasty materials used in a tertiary care centre. Methods This retrospective case series included 20 patients who underwent cranioplasty following DC between 2022 and 2024. Patients were grouped based on the material used: autologous bone (n = 6), titanium mesh (n = 9), and patient-specific titanium implants (n = 5). Preoperative evaluation included imaging and laboratory workup to rule out infection and ensure surgical readiness. Postoperative outcomes, complications, cosmetic results, and material costs were assessed over a 6–18-month follow-up period. Results Autologous bone was associated with a 33% bone flap resorption rate and 17% infection rate. Titanium mesh had one case of implant exposure (11%) but yielded good cosmetic outcomes with moderate cost. Patient-specific implants had no complications and excellent aesthetics but were the most expensive option. Early cranioplasty was not associated with a rise in postoperative complications among any patient groups. Conclusion The results associated with cranioplasty can differ significantly based on the type of material used. Autologous bone grafts frequently comes with a higher risk of complications. Titanium mesh offered balanced outcomes, while patient-specific implants provided optimal aesthetics and safety at a higher cost. Early cranioplasty is a safe and effective strategy in well-selected patients.