Cranioplasty in neurosurgery: is there a way to reduce complications?
| Autor: | Nicola Acciarri, Giorgio Palandri, Andrea Cuoci, Giuseppe Lanzino, Adelaide Valluzzi |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Adult male Adolescent medicine.medical_treatment Neurosurgery Prosthesis Neurosurgical Procedures 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications medicine Humans Child Aged Retrospective Studies Aged 80 and over business.industry Surgical procedures Middle Aged Plastic Surgery Procedures Autologous bone Cranioplasty Surgery 030220 oncology & carcinogenesis Concomitant Child Preschool Female Neurology (clinical) Complication business 030217 neurology & neurosurgery Craniotomy |
| Zdroj: | Journal of neurosurgical sciences. 64(1) |
| ISSN: | 1827-1855 |
| Popis: | BACKGROUND Cranioplasty (CPL) is a surgical procedure that has still a high rate of complications, although it is commonly considered an easy and routine operation. In the literature, cranioplasty complications may rise up to 41% of cases, and the most frequently reported are infections, autologous bone flap resorption, and hematomas. Although possible, poor cosmetic results are rarely mentioned. METHODS We retrospectively analyzed the cases of 313 patients who underwent 377 surgical procedures for cranioplasty and reoperations for complications between 2008 and 2014. In other 2 patients we performed a new surgical procedure for the prosthesis fracture. Pediatric patients (aging from 5 to 17 years) have been included in this series in order to compare the complication rate between adult and pediatric populations. The clinical-radiological follow-up of these 313 patients lasted between 1 and 6 years. RESULTS Overall complications for cranioplasty were seen in 38 (12.14%) out of the 313 patients. However, complications requiring surgical therapy were seen in 28 patients who underwent 64 new surgical procedures. Adult male patients represented the majority of the group with cranioplasty complications. In the pediatric group we have not observed any complication requiring more than a clinical observation. Infections and autologous bone resorption were the most frequent complications reported in this series; however, we observed a poor cosmetic result as a concomitant but separate complication in more than 26% of our 313 patients. CONCLUSIONS In this paper we present an overview of all the possible complications of cranioplasty reported in the literature, comparing them with those observed in our series. We also discuss critically the most evident causes of complications, suggesting, when possible, solutions to avoid or limit them. |
| Databáze: | OpenAIRE |
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