Progressive Scalp Thinning Over Mesh Cranioplasty and the Role of Lipotransfer

Wang, Weitao; Vincent, Aurora G.; Bahrami, Arash; Shokri, Tom; Inman, Jared C.; Ducic, Yadranko

doi:10.1002/lary.28463

Cited by 8 publications

(10 citation statements)

References 20 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With regard to other independent risk factors leading to scalp thinning, our findings were consistent with those in previous studies. 16 , 17 A higher incidence of soft-tissue atrophy was found in irradiated patients and in those undergoing chemotherapy. Interestingly, the larger size of the defect in this study was not associated with more extensive soft-tissue atrophy.…”

Section: Discussionmentioning

confidence: 98%

“…1 and 2 ). 16 , 17 Soft-tissue atrophy has been reported to occur over a number of different materials in a variety of locations, including facial implants, breast prostheses, and tissue expanders. 18 – 21 However, to date, there are limited data on the soft-tissue atrophy, which occurs over materials used for cranial reconstruction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term Effect of Cranioplasty on Overlying Scalp Atrophy

Kwiecień

Sinclair

Coombs

et al. 2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Scalp thinning over a cranioplasty can lead to complex wound problems, such as extrusion and infection. However, the details of this process remain unknown. The aim of this study was to describe long-term soft-tissue changes over various cranioplasty materials and to examine risk factors associated with accelerated scalp thinning. Methods: A retrospective review of patients treated with isolated cranioplasty between 2003 and 2015 was conducted. To limit confounders, patients with additional scalp reconstruction or who had a radiologic follow-up for less than 1 year were excluded. Computed tomography or magnetic resonance imaging was used to measure scalp thickness in identical locations and on the mirror image side of the scalp at different time points. Results: One hundred one patients treated with autogenous bone (N = 38), polymethylmethacrylate (N = 33), and titanium mesh (N = 30) were identified. Mean skull defect size was 104.6 ± 43.8 cm2. Mean length of follow-up was 5.6 ± 2.6 years. Significant thinning of the scalp occurred over all materials (P < 0.05). This was most notable over the first 2 years after reconstruction. Risk factors included the use of titanium mesh (P < 0.05), use of radiation (P < 0.05), reconstruction in temporal location (P < 0.05), and use of a T-shaped or “question mark” incision (P < 0.05). Conclusions: Thinning of the native scalp occurred over both autogenous and alloplastic materials. This process was more severe and more progressive when titanium mesh was used. In our group of patients without preexisting soft-tissue problems, native scalp atrophy rarely led to implant exposure. Other risk factors for scalp atrophy included radiation, temporal location, and type of surgical exposure.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Long-term Effect of Cranioplasty on Overlying Scalp Atrophy

Kwiecień

Sinclair

Coombs

et al. 2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…28 In patients with skin thinning over prior cranioplasty, lipotransfer is a useful technique in decreasing the need for secondary reconstruction. 43 Complete scalp avulsion is a rare traumatic injury that typically involves long hair becoming caught in machinery. 1 Due to this mechanism of injury, the scalp is typically avulsed either at the hairline or at the level of the supraorbital rim, therefore, not uncommonly including the eyebrows.…”

Section: Free Tissue Transfermentioning

confidence: 99%

Scalp and Forehead Injury: Management of Acute and Secondary Defects

et al. 2021

View full text Add to dashboard Cite

The primary challenges in scalp reconstruction are the relative inelasticity of native scalp tissue and the convex shape of the calvarium. All rungs of the reconstructive ladder can be applied to scalp reconstruction, albeit in a nuanced fashion due to the unique anatomy and vascular supply to the scalp. Important defect variables to incorporate into the reconstructive decision include site, potential hairline distortion, size, depth, concomitant infection, prior radiation therapy, planned adjuvant therapy, medical comorbidities, patient desires, and potential calvarium and dura defects.

show abstract

“…In the experience of the senior author, titanium mesh complications include scalp thinning and ultimate hardware exposure that may occur several years after initial implantation. 30 Banked autologous bone had a 40% resorption rate, and thus alloplastic options may be a suitable alternative when autologous cranioplasty is insufficient in defect repair.…”

Section: Autologous Grafts and Alloplastic Materialsmentioning

confidence: 99%

Cranioplasty

et al. 2021

Self Cite

View full text Add to dashboard Cite

Calvarial defects are commonly encountered after neurosurgical procedures, trauma, and ablative procedures of advanced head neck cancers. The goals of cranioplasty are to provide a protective barrier for the intracranial contents, to restore form, and prevent syndrome of the trephined. Autologous and alloplastic techniques are available, each with their advantages and drawbacks. A multitude of materials are available for cranioplasty, and proper timing of reconstruction with attention to the overlying skin envelope is important in minimizing complications.

show abstract

Progressive Scalp Thinning Over Mesh Cranioplasty and the Role of Lipotransfer

Cited by 8 publications

References 20 publications

Long-term Effect of Cranioplasty on Overlying Scalp Atrophy

Long-term Effect of Cranioplasty on Overlying Scalp Atrophy

Scalp and Forehead Injury: Management of Acute and Secondary Defects

Cranioplasty

Contact Info

Product

Resources

About