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With the advent of 3D printing in surgical training, producing realistic cranial bone models can benefit cranio-surgical training greatly. This includes the measurements of the individual layers of the skull. Hence, we have done this systematic review to identify the calvarial thickness measurement in the literature, if the different modalities affect the thickness and if calvarial thickness in human and cadaveric samples differ. Method Our literature search explored the terms, “Calvarium thickness” and “Cranial thickness” on PubMed and Google Scholar databases. A total of 6871 papers were identified and following the implementation of the PRISMA criteria, 7 papers were included in this review. Our inclusion criterias are studies that report on thickness, density and porosity, samples obtained from people greater than 20 years old and studies that included parietal bones and frontal bones. Results Our review identified inconsistent results with the thickness of the inner and outer table in the frontal bone. The results for the parietal bone were more consistent, which shows that the diploe is the thickest, followed by the outer table then the inner table. The porosity for the different layers in both parietal and frontal bones were consistent with the highest in the diploe and lowest in the outer table. CT scans showed similar measurements across different studies and are more accurate than ultrasound. However, the lack of standardised protocol could have resulted in the heterogeneous results obtained. Conclusions Our findings from this systematic review will provide insight into some of the improvements needed for future studies and applications.

128 Thickness and Porosity of the Human Calvarium Layers: A Systematic Review