3D-Printed Patient-Specific Polyetheretherketone (PEEK) Implants for Cranioplasty: A Retrospective Analysis of 50 Cases With Focus on Subcutaneous Fluid Collection Management

OBJECTIVE: To investigate the clinical value, safety, and efficacy of polyetheretherketone (PEEK) materials in cranioplasty for cranial defects. METHODS: A retrospective analysis was conducted on the clinical data of 50 patients who underwent cranioplasty with patient-specific PEEK implants at our hospital between January 2023 and January 2025. All patients underwent thin-slice cranial CT with 3D reconstruction preoperatively. PEEK implants were fabricated using computer-aided design/computer-aided manufacturing (CAD/CAM) technology combined with 3D printing, and inlay cranioplasty was performed under general anesthesia. Perioperative indicators and postoperative complications were recorded. Patients were followed up for 6 to 24 months to evaluate shaping satisfaction and long-term prognosis. RESULTS: All 50 patients successfully completed the surgery. The operative time ranged from 100 to 180 minutes (mean: 135.2±22.6 min), intraoperative blood loss was 70 to 300 mL (mean: 128.5±45.3 mL), and postoperative hospital stay was 10 to 18 days (mean: 13.6±2.4 d). All incisions achieved primary healing by first intention. Postoperative complications included subcutaneous fluid collection in 18 cases (36.0%), which resolved after compression bandaging or puncture aspiration; small epidural hematoma in 1 case (2.0%), which absorbed after conservative treatment; and postoperative seizures in 2 cases (4.0%), which were controlled with medication. No severe complications such as incision/intracranial infection, implant exposure/loosening/deformation, or rejection reaction occurred. During follow-up, no delayed complications were observed. Cranial CT/MRI examinations showed no metal artifact interference, the overall shaping satisfaction rate reached 96.0%, symptoms related to cranial defects were significantly relieved, and neurological function and quality of life were markedly improved. CONCLUSIONS: PEEK materials exhibit excellent biocompatibility, mechanical properties matching those of natural skull bone, and precise individualized shaping effects. They are safe and effective for cranioplasty, with low postoperative complication rates and superior aesthetic outcomes. PEEK represents an ideal material for cranial defect repair and has good clinical promotion value.