Paulo Valdeci Worm1, Nelson Pires Ferreira2, Guilherme Finger3, Marcus Vinicius Martins Collares4. 1. Post Graduation Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Neurological Surgery, São Jose Hospital, Santa Casa Hospital Complex, Porto Alegre, RS, Brazil; Neurosurgery Department of Cristo Redentor Hospital, Porto Alegre, RS, Brazil. Electronic address: paulo.worm@ufrgs.br. 2. Department of Neurological Surgery, São Jose Hospital, Santa Casa Hospital Complex, Porto Alegre, RS, Brazil. 3. Neurosurgery Department of Cristo Redentor Hospital, Porto Alegre, RS, Brazil. 4. Post Graduation Program in Medicine: Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Plastic and Craniomaxillofacial Surgery, Hospital de Clínicas of Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Abstract
BACKGROUND: Esthetic deformities in the human skull are a subject of concern among neurosurgical patients and neurosurgeons; they can be disfiguring and harm the patient's social relationships. To access inner structures, neurosurgical operations require skull trepanation, a process that frequently involves loss of bone tissue and leads to esthetic problems. Satisfactory reconstruction is a challenge, and neurosurgeons search for an implant which ideally is organic and low cost and does not cause an immunological or allergic reaction. Therefore, autologous bone tissue remains the gold standard for reconstruction. OBJECTIVES: To develop a technique that allows neurosurgeons to rebuild the trepanation hole with a better esthetic outcome. METHOD: Craniotomy orifices in 108 patients were closed with a graft obtained from the cranial bone inner layer. In order to remove the graft a specially made trephine was used. RESULTS: No grafts dislocated during follow-up. Cosmetic outcomes and results seen on image examinations were favorable for this new technique when compared with others previously described in medical literature. CONCLUSION: The authors present a new and feasible trepanation reconstruction technique that allows a better esthetic outcome without increasing the surgical risk for the patient, or making the surgical procedure longer or more expensive.
BACKGROUND: Esthetic deformities in the human skull are a subject of concern among neurosurgical patients and neurosurgeons; they can be disfiguring and harm the patient's social relationships. To access inner structures, neurosurgical operations require skull trepanation, a process that frequently involves loss of bone tissue and leads to esthetic problems. Satisfactory reconstruction is a challenge, and neurosurgeons search for an implant which ideally is organic and low cost and does not cause an immunological or allergic reaction. Therefore, autologous bone tissue remains the gold standard for reconstruction. OBJECTIVES: To develop a technique that allows neurosurgeons to rebuild the trepanation hole with a better esthetic outcome. METHOD: Craniotomy orifices in 108 patients were closed with a graft obtained from the cranial bone inner layer. In order to remove the graft a specially made trephine was used. RESULTS: No grafts dislocated during follow-up. Cosmetic outcomes and results seen on image examinations were favorable for this new technique when compared with others previously described in medical literature. CONCLUSION: The authors present a new and feasible trepanation reconstruction technique that allows a better esthetic outcome without increasing the surgical risk for the patient, or making the surgical procedure longer or more expensive.
Authors: Harald Binder; Daniel Schallmeiner; Thomas M Tiefenboeck; Stephan Payr; Markus Winnisch; Richard Kdolsky; Stefan Hajdu; Gilbert Manuel Schwarz; Marcus Hofbauer Journal: Int J Environ Res Public Health Date: 2022-02-25 Impact factor: 3.390