Cranioplasty: Review of materials and techniques

Aydın, Seçkin; Küçükyürük, Barış; Abuzayed, Bashar; Aydın, Sabri; Sanuş, Galip Zihni

doi:10.4103/0976-3147.83584

Cited by 284 publications

(221 citation statements)

References 19 publications

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“…It is difficult to state the exact number of particular types of cranioplastic substances. The majority of cranial recon structions seems to be performed with poly methyl meth acrylate (PMMA) (known also as bone cement), accord ing to estimates by 2 producers interviewed on that matter and based on the review of literature [7,8]. A substance which seems to have some important ad vantages over other materials used for cranioplastic pur poses in the past was created in Łódź in mid 1980s.…”

Section: Methodsmentioning

confidence: 84%

Cranioplasty as the return-to-work factor – 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University Of Lodz

Kasprzak

Ormezowska

Jaskólski

2017

Int J Occup Med Environ Health

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Objectives: The number of craniectomies and the consequent reconstructive procedures has grown during the past decades. Cranial defects and methods of their repair could have some influence on work capability of the patients and their employ ability. Material and Methods: The authors analyzed a group of 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University of Lodz, Poland, in the course of the katamnestic period longer than 6 months after reconstructive operation, and observed them between February 2008 and February 2015. Their work capability and employment were compared, all the patients were interviewed concerning the reasons for not working according to the So cial Insurance Institution predication procedure. Results: Before the cranioplasty, all the patients were capable of work ing without limitations according to biological criteria and 89 of them were employed. Twenty-three not working people consisted of 6 pupils, 7 retired and 10 not working for other reasons. During the period between the craniectomy and the cranioplasty, 88 patients were capable of working and only 2 were employed. After the reconstruction, 93 were capable of working without limitations and 16 -with limitations. Forty-seven were employed during the period of the follow-up, the rest of patients consisted of 2 pupils, 13 retired and 50 not working for various reasons. Conclusions: Cranioplasty is a very important factor contributing to return to work. This outcome may be seen as having a great social value and be add ed to the functions of cranial repair as protective, esthetic and normalizing the intracranial pressure previously described in the literature. Int J Occup Med Environ Health 2017;30(5):803-809

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Section: Methodsmentioning

confidence: 84%

Cranioplasty as the return-to-work factor – 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University Of Lodz

Kasprzak

Ormezowska

Jaskólski

2017

Int J Occup Med Environ Health

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“…1 However, we strongly recommend against using alloplastic material for pediatric cranial vault remodeling, as alloplastic materials cannot expand with the rapidly growing brain and are associated with higher rates of infection and extrusion. 7–9,25,26 In cases of craniosynostosis repair, complications are minimized when splitting cranial bone because a craniotomy is already required. Furthermore, this technique does not require additional operative time because the bone is split while the neurosurgeons finish their portion of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Split Cranial Bone Grafting in Children Younger Than 3 Years Old

Vercler

Sugg

Buchman

2014

Plastic &Amp; Reconstructive Surgery

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Background In cranioplasty patients split cranial bone provides excellent structural support and fundamentally “replaces like with like.” However, traditional teaching in craniofacial surgery is that cranial bone cannot be split before the age of 3 years because of the lack of diploic space. The authors have found this not to be the case and describe their experience with splitting cranial bone in children with craniosynostosis younger than 3 years. Methods The authors completed a retrospective review of 418 cranioplasties performed between 1997 and 2013 by a single surgeon on patients younger than 3 years with syndromic and nonsyndromic craniosynostosis. Average patient age at the time of the procedure was 328 days. The youngest patient was 58 days old. Results Of the 418 cranial procedures performed in this study, cranial bone could be split and used as bone graft in every case. Although the presence of Lückenschädel prevented a complete split of the inner table from the outer table of the bone flap, split cranial bone grafting could still be performed, providing significant grafting material to foster reconstruction. No complications from split cranial harvest were observed. Conclusions Contrary to popular belief and the misconception perpetuated by the Plastic Surgery In-Service Examination, the cranium of children younger than 3 years can indeed be safely and predictably split between the inner and outer cortex. This important finding provides the craniofacial surgeon with a valuable, expanded source of rigid bone for cranial vault remodeling in the pediatric patient population. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.

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“…Early cranioplasties date back to 3000 BC,[35] and the challenge of not just “filling a hole” but creating an adequate topographical substitute for a cranial defect has led to a numerous array of biomaterials including bone autografts, allografts, and xenographs; metals such as aluminum, gold, silver, and titanium; celluloids, PMMA, polyethylene, silicon, and many others. [235]…”

Section: Discussionmentioning

confidence: 99%

Cranioplasty with polymethylmethacrylate prostheses fabricated by hand using original bone flaps: Technical note and surgical outcomes

Caro-Osorio

Ramos²,

Martínez-Sánchez³

et al. 2013

Surg Neurol Int

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Background:Decompressive craniectomies (DC) mandate future cranioplasties, accounting for the large array of biomaterials for this purpose. Polymethylmethacrylate (PMMA) is a very reliable thermoplastic that can be prefabricated or even molded intraoperatively to create an adequate prosthesis. Preformed PMMA implants made by hand have been superseded by newer 3-D printed implants, but this is accompanied by higher costs and timing issues, apart from having limited availability in developing and third-world countries.Methods:A total of 26 patients were operated over a span of 11 years. A total of 26 custom hand-made PMMA prostheses were fabricated using original bone flaps with the aid of a prosthodontist, in a process that took approximately 70 minutes for each implant. The result was an exact duplication of the patient's bone flap.Results:Of the 26 patients who underwent cranioplasty, the majority of patients were males, with a mean age of 39.2 years and traumatic brain injury as main indication for DC. After a mean interval of 2.4 months, all 26 patients underwent a cranioplasty and prosthesis placement. Only two patients (7.6%) suffered from direct cranioplasty-related complications after a median follow-up of 10.4 months. Median Glasgow Outcome Scale scores improved significantly from 3 to 4 after cranioplasty (P = 0.008).Conclusion:Prefabrication of custom PMMA prostheses by hand when original bone flaps are available is an excellent alternative to newer 3-D printing techniques, because it is relatively cheaper, less time consuming, and offers excellent results in terms of anatomical reconstruction and improvement of neurological function in long-term follow-ups.

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Cranioplasty: Review of materials and techniques

Cited by 284 publications

References 19 publications

Cranioplasty as the return-to-work factor – 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University Of Lodz

Cranioplasty as the return-to-work factor – 112 patients with cranial defects treated in the Department of Neurosurgery at the Medical University Of Lodz

Split Cranial Bone Grafting in Children Younger Than 3 Years Old

Cranioplasty with polymethylmethacrylate prostheses fabricated by hand using original bone flaps: Technical note and surgical outcomes

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