A Prospective Comparative Study of Different Methods of Cranioplasty: Our Institutional Experience

Abstract

Introduction Cranioplasty is the surgical repair, reconstruction, and replacement of a removed part of the cranium, thus restoring its shape, symmetry, contour, and continuity, which is extremely important from a cosmetic as well as a psychosocial point of view. Continuing advances in cranioplasty techniques have enabled the repair of large and increasingly complicated calvarial defects; however, the optimal reconstructive material for different clinical scenarios still remains unclear and debatable. Aim The aim of this study was to compare risk factors, complications, and the need for reoperation associated with different methods of cranioplasty, which are implemented in our institute. Materials and Methods This study was a prospective study conducted between August 2016 and January 2019 in a tertiary institute. Sixty patients were studied and divided into three groups of which group 1 included 18 patients who underwent cranioplasty using ETO (ethylene oxidation)-sterilized autologous bone graft, group 2 included 17 patients who underwent cranioplasty using autologous bone graft placed in subcutaneous pocket, and group 3 included 25 patients who underwent titanium mesh cranioplasty. Data were collected and statistical analysis was performed. Result and Conclusion Of the three groups studied, postoperative complications were more in group 1(ETO-sterilized autologous bone graft) and group 3 (titanium mesh cranioplasty) but the difference between the three groups was not statistically significant. Factors such as age, gender, initial diagnosis, interval between decompression craniectomy and cranioplasty, operative time, blood loss, method of fixation, and defect size had no statistically significant effect on postoperative outcomes.

Craneoplastia con hueso autólogo criopreservado en pacientes craniectomizados por trauma craneal, una opción vigente y segura: experiencia de 97 casos

“…Se cree que en los colgajos óseos con múltiples fragmentos son el mecanismo patológico subyacente 11 . La aplicación de implantes de cráneo sintéticos es un método válido para evitar el riesgo de reabsorción; sin embargo, el riesgo aumentado de infección 7 y rechazo, los costos más altos y la imperfección del implante no justifican el uso de materiales aloplásticos 12 .…”

High-Density Porous Polyethylene Implant Cranioplasty: A Systematic Review of Outcomes

“…Both autologous bone flaps/grafts, and alloplastic implants such as hydroxyapatite (HA), titanium, polymethylmethacrylate (PMMA), polyetheretherketone (PEEK), and high-density porous polyethylene (HDPP) have been used to restore skull continuity. While autologous bone is considered the first reconstructive option due to biocompatibility, similar strength and elasticity, osteoconduction, and resistance to infection and extrusion, [1][2][3][4][5][6] its use is limited by bone resorption, donor site morbidity, and availability, limiting complete reconstruction of large defects.…”