How Are HTR-PMI Cranial Implants Made and Surgically Placed?

Q: I am studying to become a radiology technologist at a local community college and I am preparing a powerpoint presentation on the skull.  I’d like to play Dr. Eppley’s HTR/PMI Cranial Implant Reconstruction video as seen on YouTube during my classroom presentation to demonstrate current medical procedures to repair and reconstruct features of the skull.  Can I please have Dr. Eppley’s permission to show his video to my class?  Also, I’d like to inform my audience to what extent x-ray and fluoroscopy C-Arms are used in HTR/PMI cranial implant reconstruction cases since these are the devices we are learning to use. Does Dr. Eppley use fluoroscopy C-Arms during these surgical procedures to assess placement of the implant? Thank you for your consideration.

A: You may certainly feel free to use my HTR/PMI video for your classroom presentation. Hopefully it will add to the value of your presentation. This method of reconstruction of large cranial defects uses a custom implant (PMI = patient matched implant) fabricated from a polymeric bone substitute known as HTR. (Hard Tissue Replacement) The implant is fabricated from a 3-D model from a CT scan taken from the patient so it is an exact fit to the skull defect. The operation for implant placement is done in an open fashion, meaning the scalp is reflected and peel back for wide exposure. Since the implant is placed under direct vision, there is no need to use any radiographic method such as a C-arm to ensure a precision fit.

Dr. Barry Eppley

Indianapolis, Indiana