Current Concepts in Restoring Acquired Cranial Defects

Kumar, Kirthi; Singla, Naresh; Gowda, Mahesh E; Kumar, Dinesh; Legha, V. S.

doi:10.1007/s13191-014-0368-9

Cited by 16 publications

(16 citation statements)

References 22 publications

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“…After the resolution of cerebral swelling and the consolidation of the clinical state, cranioplasty (CP) is performed, not only as a cosmetic and protective measure, but because of curative effects on cerebral hemodynamics and metabolism 82433). Various materials have been used for CP, including autologous bone, polymethyl methacrylate (PMMA), ceramics, hydroxyapatite, polyetheretherketone, carbon-fiber-reinforced polymer and titanium 1). There is still no consensus on the ideal materials.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Kim

Kang

Cheong

et al. 2017

Korean J Neurotrauma

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ObjectiveThe aims of current study are to compare complications following cranioplasty (CP) using either sterilized autologous bone or polymethyl methacrylate (PMMA), and to identify the risk factors for two of the most common complications: bone flap resorption (BFR) and surgical site infection (SSI).MethodsBetween January 2004 and December 2013, 127 patients underwent CP and were followed at least 12 months. Variables, including sex, age, initial diagnosis, time interval between decompressive craniectomy (DC) and CP, operation time, size of bone flap, and presence of ventriculo-peritoneal shunt, were analyzed to identify the risk factors for BFR and SSI.ResultsA total of 97 (76.4%) patients underwent CP using PMMA (Group I) and 30 (23.6%) underwent CP using autologous bone (Group II). SSI occurred in 8 (8.2%) patients in Group I, and in 2 (6.7%) in Group II; there was no statistically significant difference between the groups (p=1.00). No statistically significant risk factors for SSI were found in either group. In Group I, there was no reported case of BFR. In Group II patients, BFR developed in 18 (60.0%) patients at the time of CP (Type 1 BFR), and at 12-month follow up (Type 2 BFR) in 4 (13.3%) patients. No statistically significant risk factors for BFR were found in Group II.ConclusionCP using sterilized autologous bone result in a significant rate of BFR. PMMA, however, is a safe alloplastic material for CP, as it has low complication rate.

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Section: Introductionmentioning

confidence: 99%

Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Kim

Kang

Cheong

et al. 2017

Korean J Neurotrauma

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“…The main aim of the cranioplasty is to provide protection to the intracranial component and improvement of disfigured esthetics. [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

Rapid prototyping technology for cranioplasty: A case series

Thakur

Chauhan

Viswambaran

et al. 2019

J Indian Prosthodont Soc

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Cranial vault defects may be acquired or congenital in origin. Rehabilitation of these patients often poses challenge to the operating team and prosthodontist. Polymethylmethacrylate is a commonly used alloplastic graft material which is used for the fabrication of cranial prosthesis. Nowadays, with the advancement in the bioengineering, custom-made template and cranial prosthesis can be made by rapid prototyping technology (RPT) by patient three-dimensional (3D) computed tomography (CT) scan images. This series of two cases explained two different techniques for the rehabilitation of the patient with frontotemporoparietal cranial defect. Case 1 had a history of cerebrovascular accident, followed by decompression craniotomy which led to frontotemporoparietal defect of the left side. This defect area was associated with the cerebrospinal fluid accumulation which made delineation of underlying bony margins difficult and interfered with conventional impression procedures. Case 2 had a road traffic accident which led to intracerebral hemorrhage followed by decompression craniotomy which resulted in frontotemporoparietal defect of the right side. The patient had a poor neuromuscular control which impedes with the upright posture of the head during impression making of the defect area. Therefore, these cases were planned to rehabilitate by RPT. In these techniques, the prosthesis was made using custom-made skull template produced by RPT, using the data of 3D-CT scan images. This technique resulted in the prosthesis with good esthetics and better fit of the prosthesis. The contours of the prosthesis were replicated in the same manner as compared to the contralateral side. RPT is an additive manufacturing technology which is now used in the field of dentistry too. This technique is easy to use; fabricate prosthesis with high precision is less time-consuming and has fewer chances of error.

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“…It should be firm and stable, resistant to infection, heat and cold. Finally, it should be economical 329)…”

Section: Bone Substitute For Cranioplastymentioning

confidence: 99%

“…and polymers (Polymethyl methacrylate [PMMA], polyethylene, poly-ether-ether ketone, poly-ether-ketone-ketone, etc. ), bioactive fiber-reinforced composite, demineralized bone matrix and so on 3934353940). Recently, custom-made prostheses for cranioplasty printed with three-dimensional printers are on market (Table 2, Figure 1).…”

Section: Bone Substitute For Cranioplastymentioning

confidence: 99%

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Review of Cranioplasty after Decompressive Craniectomy

Cho

Kang

2017

Korean J Neurotrauma

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Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.

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Current Concepts in Restoring Acquired Cranial Defects

Cited by 16 publications

References 22 publications

Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Rapid prototyping technology for cranioplasty: A case series

Review of Cranioplasty after Decompressive Craniectomy

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