Autologous bone dust technique for one burr hole surgery to prevent severe skin depression

Ichimura, Shinya; Fukuchi, Masahito; Takahara, Kento; Nakaya, Mitsuru; Yoshida, Keisuke; Mochizuki, Y; Fujii, Koji

doi:10.1016/j.clineuro.2018.11.019

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…Some have proposed the possibility of using buttons made of bone autografts, obtained from the inner table of the bone flap, to guarantee that there is no reaction to foreign materials and make the end of the surgery easier 2 . This is in line with another usual clinical practice: filling the burr holes with a pastry made of wet bone dustharvested from the patient at the beginning of the procedure-, to facilitate bone regeneration in the area 3,4 . This is an inexpensive method, easy to use and that can also offer a mostly positive cosmetic outcome.…”

supporting

confidence: 79%

Safety and Performance of a New Burr Hole Covering Device: Results of the Multicenter COVER Registry

Asencio-Cortés

Villalba

Vilalta

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Background: Burr-hole covering in brain surgical procedures can avoid complications and unaesthetic results. Study Aim: The aim of this registry was to assess the safety and performance of a new polymeric burr hole covering device (Cranial COVER, NEOS Surgery). Patients and Methods: A multicentere, prospective, clinical registry was used for the study. All patients that fulfilled inclusion criteria were included in the study and followed up for 6 months. Baseline clinical parameters, surgical variables (technical success of the implantation, surgeon satisfaction), post-operative variables (aesthetic and functional results, neuroimage artifacts) and adverse events were evaluated. Results: Forty-three Cranial COVER devices were implanted in 30 patients. Most of them were implanted in frontal locations (53.5%). After implantation, 97.7% of the devices completely covered the burr hole, and 100% perfectly adapted to the skull surface. All surgeons ranked their satisfaction with the implantation procedure as very high or high. No artifacts were detected in any of the neuroimages performed and no adverse events related with the device or its implantation were reported during the follow-up. There were significantly more scalp depressions associated with uncovered than with Cranial COVER-covered burr holes (P=0.040). Patient satisfaction with covered burr holes located in frontal and parietal areas was 9.0±1.4 over 10. Conclusion: Cranial COVER is a safe and reliable burr hole covering system that offers excellent cosmetic results and high satisfaction rates for both surgeons and patients. Cranial COVER is highly adaptable to the skull surface, and it was predominantly used in frontal locations due to their cosmetic importance.

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supporting

confidence: 79%

Safety and Performance of a New Burr Hole Covering Device: Results of the Multicenter COVER Registry

Asencio-Cortés

Villalba

Vilalta

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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“…There are many reports on cranioplasty to cover large bone defects, but few on scalp depression associated with a small skull defect due to burr hole trephination, as this defect tends to be overlooked by surgeons as an unimportant complication. However, despite their minor size, these defects could result in bothersome cosmetic problems and may be considered a stigmatizing mark by some patients 2,4 . Many materials have been introduced to repair such defects, including organic substitutes such as autologous bone, muscle, or fatty tissue; synthetic substitutes such as polymethyl methacrylate, hydroxyapatite, or polyethylene; and metallic substitutes 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Various materials have been proposed to fill such defects, including burr hole covers, autologous bone dust, and allogenic acellular dermal matrix. [1][2][3][4] However, to the best of our knowledge, there are no reports on the reconstruction of decades-old depressed scars from burr hole surgery. Here, we present the case of a patient with an old, depressed scar after burr hole surgery 27 years prior.…”

mentioning

confidence: 99%

“…After the brain lesion has improved, the remaining postsurgical scarring can negatively affect the quality of life. Various materials have been proposed to fill such defects, including burr hole covers, autologous bone dust, and allogenic acellular dermal matrix 1–4 . However, to the best of our knowledge, there are no reports on the reconstruction of decades-old depressed scars from burr hole surgery.…”

mentioning

confidence: 99%

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Aesthetic Reconstruction of an Old Burr Hole Defect Using a Cancellous Bone Chip and a Porous Polyethylene Implant

Lee,

Jeon,

Rha

2023

Journal of Craniofacial Surgery

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Burr hole trephination is a minimally invasive procedure but can leave a depressed scar at the surgical site. Various materials have been studied to fill such defects; however, to the best of our knowledge, there are no reports of reconstructing old, depressed scars from burr hole surgery. This report presents a patient with depressed scarring near the anterior hairline of the frontal bone on both sides due to burr hole trephination for a subdural hematoma 27 years prior. Computed tomography scans revealed bony defects under the scar. Reconstruction of the bony defect was performed by debriding the bony bed, filling it with hydrated alloplastic cancellous bone, and covering it with a porous SynPOR polyethylene titanium-reinforced implant. During 1 year of follow-up, the reconstruction was maintained without complications. The patient was satisfied with the esthetic outcome. Thus, old bony defects can be repaired using the appropriate materials and techniques.

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“…Many materials such as autologous bone, muscle, fat tissue, and synthetic or metallic substitutes have been used to prevent skull defects. 2 5 12 22 23) In 2014, the clinical efficacy of a titanium burr hole cover was evaluated in our institute. 6) This material was effective cosmetically and functionally; however, several complications were expected, such as screw loosening, displacement of burr hole cover, implant protrusion, and scalp perforation.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Allogenic Acellular Dermal Matrix for Prevention of Scalp Depression after Burr Hole Trephination

Choi

Lee

Suh

et al. 2020

Korean J Neurotrauma

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Objective Burr hole trephination is a common treatment for chronic subdural hematoma, intracranial hematoma, and intraventricular hematoma due to its effective drainage of hematoma, minimal invasiveness and short operation time. However, cosmetic complications such as scalp depression can occur. The aim of this study was to evaluate the usefulness of an allogenic acellular dermal matrix (ADM) to prevent scalp depression at the burr hole site. Methods A retrospective analysis was performed with 75 cases in 66 patients who were treated with burr hole trephination from January 2018 to December 2019. These cases divided into 2 groups; based on the method used to cover the burr hole site: Gelfoam packing only (GPO) and ADM. The degree of the scalp depression was measured from the more recent follow-up brain computed tomography scan. Results There was a significant difference in the degree of scalp depression between GPO and ADM groups ( p =0.003). No significant correlation between patient's age and the degree of scalp depression (GPO: p =0.419, ADM: p =0.790). There were no wound infection complication in either group. Conclusion ADM is a suitable material to prevent scalp depression after burr hole trephination.

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Autologous bone dust technique for one burr hole surgery to prevent severe skin depression

Cited by 5 publications

References 9 publications

Safety and Performance of a New Burr Hole Covering Device: Results of the Multicenter COVER Registry

Safety and Performance of a New Burr Hole Covering Device: Results of the Multicenter COVER Registry

Aesthetic Reconstruction of an Old Burr Hole Defect Using a Cancellous Bone Chip and a Porous Polyethylene Implant

Usefulness of Allogenic Acellular Dermal Matrix for Prevention of Scalp Depression after Burr Hole Trephination

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