Reconstruction of Large Calvarial Defects Using Titanium Mesh Versus Autologous Split Thickness Calvarial Bone Grafts: A Comprehensive Comparative Evaluation of the Two Major Cranioplasty Techniques

Jeyaraj, Priya

doi:10.1007/s12663-017-1047-2

Cited by 11 publications

(19 citation statements)

References 18 publications

(14 reference statements)

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“…The difference among the three groups was not statistically significant. Cosmetically unsatisfactory outcome was observed in 3.5% of patients with synthetic material cranioplasty and 15% of patients with autologous cranioplasty in the study conducted by Jaakko et al In the study conducted by Jeyaraj et al, 10 cosmetically unsatisfactory outcome was seen in 5% of patients who underwent titanium mesh cranioplasty and in 50% of patients who had underwent autologous split thickness calvarial bone graft cranioplasty.…”

Section: Discussionmentioning

confidence: 97%

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

Sable

Patel

Shah

2020

Indian Journal of Neurosurgery

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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.

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Section: Discussionmentioning

confidence: 97%

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

Sable

Patel

Shah

2020

Indian Journal of Neurosurgery

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“…21,23 The intrinsic osteogenic and osteoinductive potential of AB promotes angiogenesis, tissue and immune system infiltration, proliferation of granulation tissue, bone growth and remodelling, and complete reintegration of the flap with the surrounding bone. 3,14 This makes the graft a feasible option even for patients with prior infections near the surgical site. 14 However, there are limitations and contraindications to the use of AB for cranial reconstructions.…”

Section: Autologous Bone Graftmentioning

confidence: 99%

“…3,14 This makes the graft a feasible option even for patients with prior infections near the surgical site. 14 However, there are limitations and contraindications to the use of AB for cranial reconstructions. The most significant problem with using an autograft for CP, specifically persevered AB, is the risk of bone flap resorption.…”

Section: Autologous Bone Graftmentioning

confidence: 99%

“…8,12,13 Currently, no single implant has proven superiority over the other available options, so the choice of material for cranial reconstruction depends heavily on the clinical presentation of the patient, characteristics of the injury, surgeon's preference, availability of resources, and the costs of different materials. 14 Consequently, both autografts and a variety of synthetic implants are used for cranial reconstruction.…”

Section: Introductionmentioning

confidence: 99%

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The Materials Utilized in Cranial Reconstruction: Past, Current, and Future

et al. 2020

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Background: Cranioplasty (CP) is associated with high complication rates compared to other common neurosurgical procedures. Several graft materials are used for CP, which may contribute to the high complication rates, but data in the literature regarding the influence of graft material on post-CP outcomes are inconsistent making it difficult to determine if, when, and to what extent the graft material impacts the rate of perioperative complications. There is an increased demand to identify and develop superior graft materials. Objective: To review and compare the indications, risks, complications, and patient results associated with the use of different graft materials for cranial reconstructions. Design: A search through EBSCO host was conducted using the keywords “craniectomy” or “decompressive craniectomy,” “cranioplasty,” and “materials.” The search was limited to literature published in the English language from 2005 until the present. Ultimately, 69 articles were included in this review. Due to the heterogeneity of the study populations, results, statistical analyses, and collecting methods, no statistical analyses could be performed. Conclusions: Several graft materials have been adapted for use in cranial reconstructions with inconsistent results making it unclear if or when one material may be indicated over others. Advances in computer-aided design have led to improved patient-specific implants, but the ideal graft material is still being sought after in ongoing research efforts. Reviewing materials currently available, as well as those in clinical trials, is important to identify the limitations associated with different implants and to guide future research.

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“…Obtaining desirable cosmetic outcomes following cranioplasty of the frontotemporoparietal region of the cranium is particularly challenging. This is in part due to the thin nature of the skin and underlying musculature in this area, as well as the prominence and visibility of this region [4]. Failure of adequate reconstruction may lead to asymmetry, contour deformities, or a sunken appearance.…”

Section: Introductionmentioning

confidence: 99%

Use of an Acellular Dermal Matrix Graft to Address a Contour Deformity in the Temporal Fossa: A Novel Application

Gupta

Oleck

Patel

et al. 2019

Cureus

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Cranioplasty of the frontotemporoparietal region is particularly challenging given the thin skin and musculature in this area, predisposing one to an increased risk of contour deformity and cosmetic dissatisfaction following surgery. Herein, we describe a 36-year-old male who initially presented with a gunshot wound (GSW) to the head and a right parietal skull fracture and underwent a revision of his cranioplasty procedure due to significant temporalis muscle atrophy, resulting in a sunken appearance of the right temporalis fossa following a craniectomy and multiple surgeries for hematoma evacuation. The patient underwent cranioplasty for definitive repair of his defect, and at follow-up, significant temporalis muscle atrophy resulted in a sunken appearance of the right temporalis fossa. A calcium phosphate bone substitute was used to fill the deformity, but dissolution and migration of the cement at follow-up necessitated a repeat cranioplasty procedure. Alloderm™ (Allergan Corp., Dublin, Ireland), an acellular dermal matrix derived from cadaveric skin, which has been previously used for dural repair, was successfully used in this study as a buffer between the skin and a cranioplasty implant to enhance cosmetic outcomes in a revision cranioplasty procedure following temporalis muscle atrophy.

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Reconstruction of Large Calvarial Defects Using Titanium Mesh Versus Autologous Split Thickness Calvarial Bone Grafts: A Comprehensive Comparative Evaluation of the Two Major Cranioplasty Techniques

Cited by 11 publications

References 18 publications

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

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

The Materials Utilized in Cranial Reconstruction: Past, Current, and Future

Use of an Acellular Dermal Matrix Graft to Address a Contour Deformity in the Temporal Fossa: A Novel Application

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