Functional and aesthetic evaluation after cranial reconstruction with polymethyl methacrylate prostheses using low-cost 3D printing templates in patients with cranial defects secondary to decompressive craniectomies: A prospective study.

Autor:	Maricevich JPBR; Department of Plastic Surgery, Hospital da Restauração, Recife, Pernambuco, Brazil., Cezar-Junior AB; Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil., de Oliveira-Junior EX; Department of Plastic Surgery, Hospital da Restauração, Recife, Pernambuco, Brazil., Veras E Silva JAM; Department of Plastic Surgery, Hospital da Restauração, Recife, Pernambuco, Brazil., da Silva JVL; Information Technology Center Renato Archer (Ministry of Science and Technology of Brazil), Campinas, Sao Paulo, Brazil., Nunes AA; Process Engineering and Materials Engineering. Works at Information Technology Center Renato Archer (Ministry of Science and Technology of Brazil), Campinas, Sao Paulo, Brazil., Almeida NS; Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil., Azevedo-Filho HRC; Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2019 Jan 15; Vol. 10, pp. 1. Date of Electronic Publication: 2019 Jan 15 (Print Publication: 2019).
DOI:	10.4103/sni.sni_149_18
Abstrakt:	Background: Cranial reconstruction surgery is a procedure used as an attempt to reestablish the cranial bone anatomy. This study evaluates the symptomatic and aesthetic improvement of patients with cranial defects secondary to decompressive craniectomies after cranial reconstruction with customized polymethyl methacrylate (PMMA) prostheses. Secondly, we aim to divide our experience in the production of these prostheses with a low-cost method. Methods: A prospective study was carried out with patients submitted to cranioplasty at the Hospital da Restauração between 2014 and 2017. A total of 63 cranioplasties were performed using customized PMMA prosthesis produced by 3D impression molds. All patients underwent a functional and aesthetic evaluation questionnaire in the preoperative period and in the sixth postoperative month. Results: Sixty-three patients underwent cranioplasty with a mean age of 33 years, ranging from 13 to 58 years, 55 males and 8 females. The mean area of the defect was 147 cm 2 . The mean postoperative follow-up of the patients was 21 months, ranging from 6 to 33 months. Fifty-five patients attended the 6-month postoperative consultation. All patients presented symptomatic improvement after reconstruction of the skull. The infection rate was 3.2%, 4.8% of extrusion, 1.6% of prosthesis fracture, 7.9% of extradural hematoma, 17.4% of reoperation, 5% of wound dehiscence, and 4.8% of removal of the prosthesis. Conclusion: Cranioplasty, with a customized PMMA prosthesis, improved the symptoms and aesthetic appearance of all operated patients. The use of prototypes to customize cranial prostheses facilitated the operative technique and allowed the recovery of a cranial contour very close to normal. Competing Interests: There are no conflicts of interest.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu