Hoehne, Julius and Werzmirzowsky, Korbinian and Ott, Christian and Hohenberger, Christoph and Hassanin, Bahaa Ghareb and Brawanski, Alexander and Schebesch, Karl-Michael (2018) Outcomes of Cranioplasty with Preformed Titanium versus Freehand Molded Polymethylmethacrylate Implants. JOURNAL OF NEUROLOGICAL SURGERY PART A-CENTRAL EUROPEAN NEUROSURGERY, 79 (3). pp. 200-205. ISSN 2193-6315, 2193-6323
Full text not available from this repository. (Request a copy)Abstract
Objective Cranioplasty reshapes the neurocranium and viscerocranium after craniectomy. Different materials have been used for cranioplasty. However, no consistent data are yet available comparing these different materials regarding indications, complications, and outcome. We report our experience with preformed titanium implants and freehand molded polymethylmethacrylate (PMMA) implants for cranioplasty. Methods This retrospective single-center analysis included 120 consecutive cranioplasty patients who had been operated between 2006 and 2013. A total of 60 patients (27 women, 33 men; mean age: 54 years) had received a preformed titanium implant and 60 patients (22 women, 38 men; mean age: 46 years) a freehand molded PMMA implant. We evaluated all demographic and procedure-related data, indications, and outcome. The longest follow-up was 5.5 years. Results The most frequent indications for cranioplasty were trauma (n = 48 [40%]), malignant infarction (n = 27 [23%]), tumor (n = 22 [18%]), spontaneous intracerebral or aneurysmal subarachnoid hemorrhage (n = 16 [13%]), revision surgery (n = 5 [4%]), and empyema (n = 2 [2%]). PMMA implants were more often associated with wound-healing disorders (p < 0.023; odds ratio [OR]: 10.53) and epidural hematoma (p < 0.03; OR: 8.46), resulting in a significantly higher re-operation rate (p < 0.005). Precise fitting was radiologically confirmed in 98% of titanium implants but in only 71% of PMMA implants (p < 0.001). Magnetic resonance imaging of patients with titanium implants (n = 4) did not show any relevant artifacts. Conclusion Cranioplasty with preformed titanium implants seems to be superior to freehand molded PMMA implants regarding surgical morbidity, revision rate, and aesthetic results.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MIDDLE-CEREBRAL-ARTERY; TRAUMATIC BRAIN-INJURY; DECOMPRESSIVE CRANIECTOMY; MALIGNANT INFARCTION; CONTROLLED-TRIAL; MULTICENTER; HEMICRANIECTOMY; COMPLICATIONS; EXPERIENCE; INFECTION; cranioplasty; craniectomy; titanium; polymethylmethacrylate; outcome |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 19 Mar 2020 14:55 |
| Last Modified: | 19 Mar 2020 14:55 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14697 |
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