Intraoperative template-molded bone flap reconstruction for patient-specific cranioplasty
| Autor: | Jürgen Beck, Serge Marbacher, Ali-Reza Fathi, Javier Fandino, Lukas Andereggen, Salome Erhardt, Andreas Raabe |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Visual analogue scale medicine.medical_treatment Dentistry 610 Medicine & health Surgical Flaps Young Adult Patient satisfaction Bone plate medicine Humans Polymethyl Methacrylate Surgical Wound Infection Aged Titanium business.industry Skull Bone Cements Cosmesis General Medicine Prostheses and Implants Middle Aged Plastic Surgery Procedures Cranioplasty Surgery Neurosurgical Procedure Treatment Outcome Patient Satisfaction Female Neurology (clinical) Implant business Tomography X-Ray Computed Bone Plates Craniotomy Follow-Up Studies |
| Zdroj: | Marbacher, Serge; Andereggen, Lukas; Erhardt, Salome; Fathi, Ali-Reza; Fandino, Javier; Raabe, Andreas; Beck, Jürgen (2012). Intraoperative template-molded bone flap reconstruction for patient-specific cranioplasty. Neurosurgical review, 35(4), 527-35; discussion 535. Berlin: Springer-Verlag 10.1007/s10143-012-0376-3 |
| ISSN: | 1437-2320 |
| DOI: | 10.1007/s10143-012-0376-3 |
| Popis: | Cranioplasty is a common neurosurgical procedure. Free-hand molding of polymethyl methacrylate (PMMA) cement into complex three-dimensional shapes is often time-consuming and may result in disappointing cosmetic outcomes. Computer-assisted patient-specific implants address these disadvantages but are associated with long production times and high costs. In this study, we evaluated the clinical, radiological, and cosmetic outcomes of a time-saving and inexpensive intraoperative method to mold custom-made implants for immediate single-stage or delayed cranioplasty. Data were collected from patients in whom cranioplasty became necessary after removal of bone flaps affected by intracranial infection, tumor invasion, or trauma. A PMMA replica was cast between a negative form of the patient's own bone flap and the original bone flap with exactly the same shape, thickness, and dimensions. Clinical and radiological follow-up was performed 2 months post-surgery. Patient satisfaction (Odom criteria) and cosmesis (visual analogue scale for cosmesis) were evaluated 1 to 3 years after cranioplasty. Twenty-seven patients underwent intraoperative template-molded patient-specific cranioplasty with PMMA. The indications for cranioplasty included bone flap infection (56%, n = 15), calvarian tumor resection (37%, n = 10), and defect after trauma (7%, n = 2). The mean duration of the molding procedure was 19 ± 7 min. Excellent radiological implant alignment was achieved in 94% of the cases. All (n = 23) but one patient rated the cosmetic outcome (mean 1.4 years after cranioplasty) as excellent (70%, n = 16) or good (26%, n = 6). Intraoperative cast-molded reconstructive cranioplasty is a feasible, accurate, fast, and cost-efficient technique that results in excellent cosmetic outcomes, even with large and complex skull defects. |
| Databáze: | OpenAIRE |
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