The history of military cranioplasty

Abstract

<jats:p>There is evidence that the neurosurgical procedure of cranioplasty is as ancient as its better-known counterpart, trephination. With origins in pre-Incan Peru, cranioplasty remains an important reconstructive procedure for modern craniofacial surgery teams to master. Solutions to the often challenging problem of repairing skull defects continue to evolve to improve patient outcomes. Throughout recorded history, advances in cranioplasty have paralleled major military conflicts due to survivorship after trephination or decompressive craniectomy. Primitive skull coverings used in Peru were later replaced during the Middle Ages by grafts obtained in animals and humans. Improved survivorship secondary to advances in anesthesia and battlefield medicine during the Crimean War and the American Civil War allowed the use of tantalum and acrylic cranioplasty to evolve during World Wars I and II. In the modern era of the Iraq and Afghanistan conflicts, greater survivorship after cranial injury due to improvements in protective armor, medical evacuation, and early “far-forward” neurosurgical treatment have occurred. Consequently, the last decade has seen great advancement in cranial defect reconstruction, including custom-fabricated alloplast implants and the emergence of regenerative cranial treatments such as distraction osteogenesis, protected bone regeneration, and free tissue transfers. Comprehensive rehabilitation after neurotrauma has emerged as the new standard of care.</jats:p>

Skull Repair Materials Applied in Cranioplasty: History and Progress

“…Tantalum represented a significant breakthrough in synthetic cranioplasty and renewed interest in the search for a suitable synthetic material for cranioprostheses. The experiences of wartime neurosurgeons with tantalum cranioplasty played a pivotal role in the evolution of modern cranioplasty techniques and ultimately led to a better understanding of the necessary attributes of an ideal synthetic cranioprostheses [11] . As it has the ability to be easily cut and shaped, tantalum meets the requirements for repairing a considerable part of cranial defects, especially those resulting from war wounds.…”

Historical overview of cranial bone implants: own material or artificial prostheses - short review

“…Nevertheless, this report is important due to the use of xenograft bone in cranioplasty for the first time in the history of medicine. In Europe, during the 16th -17th centuries, literature reports the use of golden or silver plates [3,6]. The first similar report to this written by Baha al-Dowleh Razi, about successful cranioplasty of animal bone graft was published in 1668 by the Dutch surgeon Job Janszoon van Meekeren [6].…”

Job van Meekeren (1611–1666) and his descriptions of posterior craniocervical masses in children

“…Job van Meekeren was a Dutch surgeon practicing in Amsterdam and who performed autopsies on many of his interesting cases. He was a student of Nicolaas Tulp (1593-1674) who referred to him as chirurgis industrius [1], and was the first to report the use of a bone xenograft (from a dog) for cranioplasty in a Russian nobleman [2]. He also performed trepanations.…”