Jaakko M Piitulainen1, Tommi Kauko2, Kalle M J Aitasalo3, Ville Vuorinen4, Pekka K Vallittu5, Jussi P Posti4. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Division of Surgery and Cancer Diseases, Turku University Hospital, Turku, Finland; Turku Clinical Biomaterials Centre, Institute of Dentistry, University of Turku, Turku, Finland. Electronic address: jaakko.piitulainen@utu.fi. 2. Department of Biostatistics, University of Turku, Turku, Finland. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Division of Surgery and Cancer Diseases, Turku University Hospital, Turku, Finland; Turku Clinical Biomaterials Centre, Institute of Dentistry, University of Turku, Turku, Finland. 4. Department of Neurosurgery, Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland. 5. Turku Clinical Biomaterials Centre, Institute of Dentistry, University of Turku, Turku, Finland.
Abstract
OBJECTIVE: Using current surgical methods, cranioplasty is associated with a high complication rate. We analyzed if there are preexisting medical conditions associated with complications and compared the effect of different implant materials on the degree of complications. METHODS: A retrospective review of the medical records of all patients who underwent cranioplasty for cranial bone defects during the period 2002-2012 was conducted, and 100 consecutive cranioplasty procedures that met eligibility criteria were identified. Patients were analyzed in 4 groups, which were created based on the cranioplasty material: autograft (n = 20), bioactive fiber-reinforced composite (n = 20), hydroxyapatite (n = 31), and other synthetic materials (n = 29). Survival estimates were constructed with Kaplan-Meier curves, and the differences between categorical variable levels were determined using a log-rank test. Multiple comparisons were adjusted using a Šidák correction. RESULTS: During a median follow-up time of 14 months (interquartile range 3-39 months), 32 of 100 patients (32.0%) developed at least 1 complication. A minor complication occurred in 13 patients (13.0%), whereas 19 patients (19.0%) developed a major complication, which required reoperation or removal of the implant. In the autograft subgroup, 40.0% of patients required removal of the cranioplasty. The 3-year survival of the autograft subgroup was lower compared with other subgroups of synthetic materials. In hydroxyapatite and bioactive fiber-reinforced composite groups, fewer complications were observed compared with the autograft group. CONCLUSIONS: Based on these results, synthetic materials for cranial bone defect reconstruction exhibit more promising outcomes compared with autograft. There were differences in survival rates among synthetic materials.
OBJECTIVE: Using current surgical methods, cranioplasty is associated with a high complication rate. We analyzed if there are preexisting medical conditions associated with complications and compared the effect of different implant materials on the degree of complications. METHODS: A retrospective review of the medical records of all patients who underwent cranioplasty for cranial bone defects during the period 2002-2012 was conducted, and 100 consecutive cranioplasty procedures that met eligibility criteria were identified. Patients were analyzed in 4 groups, which were created based on the cranioplasty material: autograft (n = 20), bioactive fiber-reinforced composite (n = 20), hydroxyapatite (n = 31), and other synthetic materials (n = 29). Survival estimates were constructed with Kaplan-Meier curves, and the differences between categorical variable levels were determined using a log-rank test. Multiple comparisons were adjusted using a Šidák correction. RESULTS: During a median follow-up time of 14 months (interquartile range 3-39 months), 32 of 100 patients (32.0%) developed at least 1 complication. A minor complication occurred in 13 patients (13.0%), whereas 19 patients (19.0%) developed a major complication, which required reoperation or removal of the implant. In the autograft subgroup, 40.0% of patients required removal of the cranioplasty. The 3-year survival of the autograft subgroup was lower compared with other subgroups of synthetic materials. In hydroxyapatite and bioactive fiber-reinforced composite groups, fewer complications were observed compared with the autograft group. CONCLUSIONS: Based on these results, synthetic materials for cranial bone defect reconstruction exhibit more promising outcomes compared with autograft. There were differences in survival rates among synthetic materials.
Authors: Olli-Pekka Lappalainen; Sakari Karhula; Marianne Haapea; Laura Kyllönen; Suvi Haimi; Susanna Miettinen; Simo Saarakkala; Jarkko Korpi; Leena P Ylikontiola; Willy S Serlo; George K Sándor Journal: Childs Nerv Syst Date: 2016-01-19 Impact factor: 1.475
Authors: Henrik Giese; Thomas Sauvigny; Oliver W Sakowitz; Michael Bierschneider; Erdem Güresir; Christian Henker; Julius Höhne; Dirk Lindner; Dorothee Mielke; Robert Pannewitz; Veit Rohde; Martin Scholz; Patrick Schuss; Jan Regelsberger Journal: BMJ Open Date: 2015-09-30 Impact factor: 2.692
Authors: Paulo Valdeci Worm; Tobias Ludwig do Nascimento; Fabricio do Couto Nicola; Eduardo Farias Sanches; Carlos Fernando Dos Santos Moreira; Luiz Pedro Willimann Rogério; Marcelo Martins Dos Reis; Guilherme Finger; Marcus Vinicius Martins Collares Journal: Surg Neurol Int Date: 2016-11-09