| Autor: |
Toh EMS; Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore., Thenpandiyan AA; Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore., Foo ASC; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Zhang JJY; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Lim MJR; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Goh CP; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Dinesh N; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Vedicherla SV; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Yang M; Division of Neurosurgery, Department of Surgery, Khoo Teck Puat Hospital, Singapore 768828, Singapore., Teo K; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Yeo TT; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore., Nga VDW; Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore 119228, Singapore. |
| Abstrakt: |
Burrhole craniostomy is commonly performed for subdural hematoma (SDH) evacuation, but residual scalp depressions are often cosmetically suboptimal for patients. Osteoplug TM , a bioresorbable polycaprolactone burrhole cover, was introduced by the National University Hospital, Singapore, in 2006 to cover these defects, allowing osseous integration and vascular ingrowth. However, the cosmetic and safety outcomes of Osteoplug TM -C-the latest (2017) iteration, with a chamfered hole for subdural drains-remain unexplored. Data were collected from a single institution from April 2017 to March 2021. Patient-reported aesthetic outcomes (Aesthetic Numeric Analog (ANA)) and quality of life (EQ-5D-3L including Visual Analog Scale (VAS)) were assessed via telephone interviews. Clinical outcomes included SDH recurrence, postoperative infections, and drain complications. Osteoplug TM -C patients had significantly higher satisfaction and quality of life compared to those without a burrhole cover (ANA: 9 [7, 9] vs. 7 [5, 8], p = 0.019; VAS: 85 [75, 90] vs. 70 [50, 80], p = 0.021), and the absence of a burrhole cover was associated with poorer aesthetic outcomes after multivariable adjustment (adjusted OR: 4.55, 95% CI: 1.09-22.68, p = 0.047). No significant differences in other clinical outcomes were observed between Osteoplug TM -C, Osteoplug TM , or no burrhole cover. Our pilot study supports Osteoplug TM -C and its material polycaprolactone as suitable adjuncts to burrhole craniostomy, improving cosmetic outcomes while achieving comparable safety outcomes. |
