[Role of cranioplasty in the management of decompressive craniectomies: Study of the Adolphe de Rothschild Foundation Hospital cohort over 7 years].

Abstract

Objectives: The objective of our study is to take stock of the cranioplasty implants used within our establishment.

Materials and method: We analyzed the patients files who underwent craniectomy followed by cranioplasty between 2017 and 2023, with at least 1 year of follow-up after cranioplasty (n=75). The data were extracted from the computerized patient file (DxCare®, Dédalus) and the pharmaceutical management tool for drugs and sterile medical devices (Pharma®, Computer Engineering). The sex ratio, indication for craniectomy, operating time, time between craniectomy and cranioplasty, complications and aesthetic result were statistically analyzed.

Results: The main indications are stroke (n=59; 78.5%) and aneurysms (n=7; 9.5%). Among the 75 patients, 52 benefited from the placement of a custom implant (PolyEtherEtherCetone/PEEK or Hydroxyapatite) and 23 from cementoplasty. The operating time was significantly shorter (P<0.05) for custom cranioplasty (1.93±0.61h vs. 1.62±0.53). Only 4 patients (5.3%) were not satisfied with the aesthetic result following the placement of a custom implant. A greater risk of infection was found in the context of cementoplasty (43% for cementoplasties vs. 25% for the custom implant, so χ² (P=0.1095), this difference not being statistically significant.

Conclusion: This collaborative work between the pharmacy and the adult neurosurgery department served to establish an initial register for monitoring patients who have undergone cranioplasty for whom the ideal implant remains to be determined.