Titanium mesh cranioplasty in pediatric patients after decompressive craniectomy: Appropriate timing for pre-schoolers and early school age children
| Autor: | Fen-chun Lin, Nu Zhang, Guo-qiang Jiang, Fang Shen, Hansong Sheng, Jian Lin, Ming Cai, Dan-Dong Li |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Decompressive Craniectomy medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Outpatient clinic Humans Child Retrospective Studies Pre schoolers Titanium School age child business.industry Skull 030206 dentistry Plastic Surgery Procedures Surgical Mesh Cranioplasty Surgery Active participation Otorhinolaryngology 030220 oncology & carcinogenesis Radiological weapon Child Preschool Decompressive craniectomy Oral Surgery business Pediatric population |
| Zdroj: | Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. 47(7) |
| ISSN: | 1878-4119 |
| Popis: | There is little knowledge on the growth of cranial defects, appropriate timing and outcomes of application of titanium mesh for cranioplasty in the pediatric population, especially pre-school age (2-5 years old) and school age (6-12 years old) children. We hypothesised that cranioplasty for pre-schoolers could be delayed to school age due to the expected cranium growth, whereas, for the school age group, it is better to perform routine cranioplasty (3-6 months) to protect the brain and therefore ensure their timely return to school life.A retrospective review of pediatric patients (2-12 years old) who underwent titanium mesh cranioplasty for cranial defects from 2006 to 2012 was performed. Patient demographic data, radiological data, and clinical information were collected. Specifically, cranial defect sizes were evaluated by three-dimensional (3D) reconstruction of computed tomography data after craniectomy, before cranioplasty and 2-years after cranioplasty. Patients were routinely followed up at an outpatient clinic for complications and school attendance.A total of 18 titanium mesh cranioplasties were performed in 18 patients. The average interval between craniectomy and cranioplasty was 3 years for pre-schoolers and 4 months for the school age group. Patients in the pre-schooler group showed significant enlargements in cranial defects during the interval as compared with the school age group (26% vs. 4%, P 0.05). There were no surgery-related complications except in one patient, who had titanium mesh exposure 11 months later. Two years after cranioplasty, there was no significant difference in mild cranial defect enlargements between the two groups (11% vs. 6%, P 0.05). Patients were followed for an average of 5 (range, 2-8) years. All patients had satisfactory recovery of cranial contour, sufficient protection of the brain and active participation in school study. All patients had satisfactory recovery of cranial contour, sufficient protection of the brain and active participation in school.Timing of titanium mesh cranioplasty after decompressive craniectomy based on their age is a workable solution for school-age pediatric patients. The enlargement of cranium defects in pre-schoolers supports a delayed repair until school age. The long-term outcomes for these patients with titanium mesh cranioplasty are favourable. |
| Databáze: | OpenAIRE |
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