To explore the potential advantages of polyetheretherketone (PEEK) material by comparing and analyzing the clinical efficacy of PEEK and titanium mesh in cranioplasty after traumatic brain injury (TBI).

Forty-eight patients who underwent cranioplasty after TBI in Neurosurgery Department of The 901^st Hospital of the Joint Logistics Support Force of PLA from January 2017 to January 2021 were analyzed retrospectively, including 20 patients who underwent cranioplasty with PEEK material (PEEK group) and 28 patients who underwent cranioplasty with titanium mesh (titanium mesh group). The intraoperative bleeding, operation time, hospital stay, postoperative complications, plastic effect and treatment cost were compared between the two groups. The patients were followed up for 12 months, and the long-term effect was observed by comparing Karnofsky functional state (KPS) score.

The sutures were removed in all patients 12-14 d after operation, the incision healed in grade A, and there were no infections and deaths. There was no significant difference in operation time, intraoperative bleeding and hospital stay between the two groups (P>0.05). The incidence of postoperative complications in PEEK group (65.00%) was similar to that in titanium mesh group (60.71%) (P>0.05), and there was no significant difference in postoperative complications such as intracranial hemorrhage, intracranial infection, subdural effusion, epilepsy and hydrocephalus between the two groups (P>0.05), but the incidence of subcutaneous effusion and total medical expenses in peek group were higher than those in titanium mesh group (P<0.05). The satisfaction of the two groups was higher, but the peek group was better than the titanium mesh group (P<0.05). After 12 months of follow-up, there was no delayed incision infection and material exposure. There was no significant difference in KPS score between the two groups 12 months after operation (P>0.05).

There was no significant difference in the overall complication rate between 3D printed peek and titanium mesh in TBI patients undergoing cranioplasty. However, the 3D printed PEEK material fits more perfectly with the skull, which is suitable for children, adolescents and female patients under the condition of good economic conditions.