A treatment algorithm for patients with large skull bone defects and first results

Lethaus, Bernd; Laak, Marielle Poort ter; Laeven, Paul; Beerens, Maikel; Koper, David; Poukens, Jules; Keßler, Peter

doi:10.1016/j.jcms.2010.10.003

Cited by 74 publications

(49 citation statements)

References 27 publications

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“…Several studies of craniofacial reconstructions have reported using polyetheretherketone (PEEK) for the construction of patientspecific implants (PSIs) (Scolozzi et al, 2007;Kim et al, 2009;Lethaus et al, 2011Lethaus et al, , 2014Ng et al, 2014). PEEK is considered to be the gold standard of alloplastic material for the construction of PSIs due to its excellent biocompatibility, good mechanical strength, and radiographic translucency (Nieminen et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Porous polyethylene implants in facial reconstruction: Outcome and complications

Ridwan-Pramana

Wolff

Raziei

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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Section: Introductionmentioning

confidence: 99%

Porous polyethylene implants in facial reconstruction: Outcome and complications

Ridwan-Pramana

Wolff

Raziei

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…No infections were observed. Lethaus et al (Lethaus et al, 2011) reported a series of 12 patients of whom four underwent a calvarial reconstruction with PEEK; only one epidural hematoma in an anticoagulated patient was observed. Ng and Nawaz (Ng and Nawaz, 2014) reconstructed 12 cranial defects with good results, and they recommended PEEK implants for cranioplasties as a viable alternative when autologous bone grafts are unavailable or unsuitable.…”

Section: Discussionmentioning

confidence: 99%

Polyetheretherketone custom-made implants for craniofacial defects: Report of 14 cases and review of the literature

Alonso-Rodríguez

Carretero

Nieto

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…11 The literature regarding PEEK cranioplasties is scant, consisting of 3 small case series of 12, 6, and 4 patients, respectively, in addition to scattered case reports. 6,8,11 Although it is quite difficult to draw conclusions with these small numbers with limited follow-up, the combined complication rate is approximately 33%. Nevertheless, the reports highly recommend PEEK implants as a cranioplasty option when the native bone is unavailable, because of the reduced operative time and technical ease of placement.…”

Section: Discussionmentioning

confidence: 99%

Minimizing bone gaps when using custom pediatric cranial implants is associated with implant success

Bowers¹,

McMullin

Brimley

et al. 2015

PED

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OBJECT Occasionally after a craniotomy, the bone flap is discarded (as in the case of osteomyelitis) or is resorbed (especially after trauma), and an artificial implant must be inserted in a delayed fashion. Polyetheretherketone (PEEK) implants and hard-tissue replacement patient-matched implants (HTR-PMI) are both commonly used in such cases. This study sought to compare the failure rate of these 2 implants and identify risk factors of artificial implant failure in pediatric patients. METHODS This was a retrospective cohort study examining all pediatric patients who received PEEK or HTR-PMI cranioplasty implants from 2000 to 2013 at a single institution. The authors examined the following variables: age, sex, race, mechanism, surgeon, posttraumatic hydrocephalus, time to cranioplasty, bone gap width, and implant type. The primary outcome of interest was implant failure, defined as subsequent removal and replacement of the implant. These variables were analyzed in a bivariate statistical fashion and in a multivariate logistic regression model for the significant variables. RESULTS The authors found that 78.3% (54/69) of implants were successful. The mean patient age was 8.2 years, and a majority of patients were male (73%, 50/69); the mean follow-up for the cohort was 33.3 months. The success rate of the 41 HTR-PMI implants was 78.1%, and the success rate of the 28 PEEK implants was 78.6% (p = 0.96). Implants with a bone gap of > 6 mm were successful in 33.3% of cases, whereas implants with a gap of < 6 mm had a success rate of 82.5% (p = 0.02). In a multivariate model with custom-type implants, previous failed custom cranial implants, time elapsed from previous cranioplasty attempt, and bone gap size, the only independent risk factor for implant failure was a bone gap > 6 mm (odds ratio 8.3, 95% confidence interval 1.2–55.9). CONCLUSIONS PEEK and HTR-PMI implants appear to be equally successful when custom implantation is required. A bone gap of > 6 mm with a custom implant in children results in significantly higher artificial implant failure.

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A treatment algorithm for patients with large skull bone defects and first results

Cited by 74 publications

References 27 publications

Porous polyethylene implants in facial reconstruction: Outcome and complications

Porous polyethylene implants in facial reconstruction: Outcome and complications

Polyetheretherketone custom-made implants for craniofacial defects: Report of 14 cases and review of the literature

Minimizing bone gaps when using custom pediatric cranial implants is associated with implant success

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