Sait Kayhan, Şahin Kırmızıgöz, Alparslan Kırık, Özkan Tehli, Yusuf İzci
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Demographic and radiological features were compared based on the materials used in the initial cranioplasty.</p><p><strong>Results: </strong>Previous material was autologous graft (AG) in 27 patients and polymethyl methacrylate (PMMA) in 16 patients. The mean time without revision cranioplasty is longer in patients with PMMA implants than in patients with AG. There was no statistically significant difference in the length of hospital stay between patients with PMMA implants and patients with AG. There were no postoperative adverse events such as infection, wound dehiscence, convulsions, and epidural hematoma in 38 patients during hospitalization. Wound dehiscence developedin 5 patients and surgical repair was required in one.</p><p><strong>Conclusion: </strong>Initial cranioplasty with PMMA provides a longer time period than the AG before the revision. However, both of them have similar outcomes based on length of hospital stay and cranial defect area. Custom-made 3D titanium implant is a good option for revision cranioplasty to prevent implant failure and reduce patients' cosmetic concerns.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Revision Cranioplasty with Three-dimensional (3D) Custom-made Titanium Implants in patients with failed cranioplasty.\",\"authors\":\"Sait Kayhan, Şahin Kırmızıgöz, Alparslan Kırık, Özkan Tehli, Yusuf İzci\",\"doi\":\"10.1016/j.wneu.2024.08.154\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Graft failure is a common complication of cranioplasty.Revision cranioplasty is required to overcome this complication. However, no previous studies have reported outcomes in revision cranioplasty with three-dimensional (3D) custom-made titanium implants. We described our experience with 3D titanium implants in patients with revision cranioplasty.</p><p><strong>Methods: </strong>We evaluated 43 consecutive patients who underwent revision cranioplasty using 3D custom-made titanium implants between January 2011 and December 2019.The 3D image of the patient's cranium and the plan to close the cranium defect were created in a virtual environment using software programs. Demographic and radiological features were compared based on the materials used in the initial cranioplasty.</p><p><strong>Results: </strong>Previous material was autologous graft (AG) in 27 patients and polymethyl methacrylate (PMMA) in 16 patients. The mean time without revision cranioplasty is longer in patients with PMMA implants than in patients with AG. There was no statistically significant difference in the length of hospital stay between patients with PMMA implants and patients with AG. There were no postoperative adverse events such as infection, wound dehiscence, convulsions, and epidural hematoma in 38 patients during hospitalization. Wound dehiscence developedin 5 patients and surgical repair was required in one.</p><p><strong>Conclusion: </strong>Initial cranioplasty with PMMA provides a longer time period than the AG before the revision. However, both of them have similar outcomes based on length of hospital stay and cranial defect area. Custom-made 3D titanium implant is a good option for revision cranioplasty to prevent implant failure and reduce patients' cosmetic concerns.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.08.154\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.08.154","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:移植失败是颅骨成形术的常见并发症。然而,以前没有研究报告过使用三维(3D)定制钛植入物进行翻修颅成形术的结果。我们介绍了在翻修颅成形术患者中使用三维钛植入物的经验:我们对 2011 年 1 月至 2019 年 12 月期间使用三维定制钛植入物进行翻修颅成形术的 43 名连续患者进行了评估。患者颅骨的三维图像和颅骨缺损闭合计划是在虚拟环境中使用软件程序创建的。根据初次颅骨成形术中使用的材料,对人口统计学和放射学特征进行了比较:结果:27 名患者使用了自体移植物(AG),16 名患者使用了聚甲基丙烯酸甲酯(PMMA)。与使用自体移植材料的患者相比,使用聚甲基丙烯酸甲酯(PMMA)移植材料的患者无需进行颅骨成形术翻修的平均时间更长。使用 PMMA 植入体的患者与使用 AG 的患者在住院时间上没有明显的统计学差异。38 名患者在住院期间没有发生感染、伤口裂开、抽搐和硬膜外血肿等术后不良事件。5例患者出现伤口裂开,1例需要手术修复:结论:与翻修前的 AG 相比,使用 PMMA 进行初次颅骨成形术的时间更长。结论:使用 PMMA 进行初次颅骨成形术的时间比翻修前使用 AG 的时间长,但从住院时间和颅骨缺损面积来看,两者的效果相似。定制的三维钛假体是翻修颅成形术的良好选择,可防止假体失效,减少患者对外观的担忧。
Revision Cranioplasty with Three-dimensional (3D) Custom-made Titanium Implants in patients with failed cranioplasty.
Objective: Graft failure is a common complication of cranioplasty.Revision cranioplasty is required to overcome this complication. However, no previous studies have reported outcomes in revision cranioplasty with three-dimensional (3D) custom-made titanium implants. We described our experience with 3D titanium implants in patients with revision cranioplasty.
Methods: We evaluated 43 consecutive patients who underwent revision cranioplasty using 3D custom-made titanium implants between January 2011 and December 2019.The 3D image of the patient's cranium and the plan to close the cranium defect were created in a virtual environment using software programs. Demographic and radiological features were compared based on the materials used in the initial cranioplasty.
Results: Previous material was autologous graft (AG) in 27 patients and polymethyl methacrylate (PMMA) in 16 patients. The mean time without revision cranioplasty is longer in patients with PMMA implants than in patients with AG. There was no statistically significant difference in the length of hospital stay between patients with PMMA implants and patients with AG. There were no postoperative adverse events such as infection, wound dehiscence, convulsions, and epidural hematoma in 38 patients during hospitalization. Wound dehiscence developedin 5 patients and surgical repair was required in one.
Conclusion: Initial cranioplasty with PMMA provides a longer time period than the AG before the revision. However, both of them have similar outcomes based on length of hospital stay and cranial defect area. Custom-made 3D titanium implant is a good option for revision cranioplasty to prevent implant failure and reduce patients' cosmetic concerns.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS