Vita M Klieverik1, Kai J Miller1, Ash Singhal2, Kuo Sen Han1, Peter A Woerdeman3. 1. Department of Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, room G03.124, 3484, CX, Utrecht, The Netherlands. 2. Division of Pediatric Neurosurgery, British Columbia Children's Hospital, B, Vancouver, C, Canada. 3. Department of Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, room G03.124, 3484, CX, Utrecht, The Netherlands. p.a.woerdeman@umcutrecht.nl.
Abstract
INTRODUCTION: Complications following cranioplasty with either autografts or cranial implants are commonly reported in pediatric patients. However, data regarding cranioplasty strategies, complications and long-term outcomes are not well described. This study systematically reviews the literature for an overview of current cranioplasty practice in children. METHODS: A systematic review of articles published from inception to July 2018 was performed. Studies were included if they reported the specific use of cranioplasty materials following craniectomy in patients younger than 18 years of age, and had a minimum follow-up of at least 1 year. RESULTS: Twenty-four manuscripts, describing a total of 864 cranioplasty procedures, met the inclusion criteria. The age of patients in this aggregate ranged from 1 month to 20 years and the weighted average was 8.0 years. The follow-up ranged from 0.4 months to 18 years and had a weighted average of 40.4 months. Autologous bone grafts were used in 484 cases (56.0%). Resorption, infection and/or hydrocephalus were the most frequently mentioned complications. In this aggregate group, 61 patients needed a revision cranioplasty. However, in 6/13 (46%) papers studying autologous cranioplasties, no data was provided on resorption, infection and revision cranioplasty rates. Cranial implants were used in 380 cases (44.0%), with custom-made porous hydroxyapatite being the most commonly used material (100/380, 26.3%). Infection and migration/fracturing/loosening were the most frequently documented complications. Eleven revision cranioplasties were reported. Again, no data was reported on infection and revision cranioplasty rates, in 7/16 (44%) and 9/16 (56%) of papers, respectively. CONCLUSION: Our systematic review illuminates that whether autografts or cranial implants are used, postcranioplasty complications are quite common. Beyond this, the existing literature does not contain well documented and comparable outcome parameters, suggesting that prospective, long-term multicenter cohort studies are needed to be able to optimize cranioplasty strategies in children who will undergo cranioplasty following craniectomy.
INTRODUCTION: Complications following cranioplasty with either autografts or cranial implants are commonly reported in pediatric patients. However, data regarding cranioplasty strategies, complications and long-term outcomes are not well described. This study systematically reviews the literature for an overview of current cranioplasty practice in children. METHODS: A systematic review of articles published from inception to July 2018 was performed. Studies were included if they reported the specific use of cranioplasty materials following craniectomy in patients younger than 18 years of age, and had a minimum follow-up of at least 1 year. RESULTS: Twenty-four manuscripts, describing a total of 864 cranioplasty procedures, met the inclusion criteria. The age of patients in this aggregate ranged from 1 month to 20 years and the weighted average was 8.0 years. The follow-up ranged from 0.4 months to 18 years and had a weighted average of 40.4 months. Autologous bone grafts were used in 484 cases (56.0%). Resorption, infection and/or hydrocephalus were the most frequently mentioned complications. In this aggregate group, 61 patients needed a revision cranioplasty. However, in 6/13 (46%) papers studying autologous cranioplasties, no data was provided on resorption, infection and revision cranioplasty rates. Cranial implants were used in 380 cases (44.0%), with custom-made porous hydroxyapatite being the most commonly used material (100/380, 26.3%). Infection and migration/fracturing/loosening were the most frequently documented complications. Eleven revision cranioplasties were reported. Again, no data was reported on infection and revision cranioplasty rates, in 7/16 (44%) and 9/16 (56%) of papers, respectively. CONCLUSION: Our systematic review illuminates that whether autografts or cranial implants are used, postcranioplasty complications are quite common. Beyond this, the existing literature does not contain well documented and comparable outcome parameters, suggesting that prospective, long-term multicenter cohort studies are needed to be able to optimize cranioplasty strategies in children who will undergo cranioplasty following craniectomy.
Authors: P D Costantino; J M Chaplin; M E Wolpoe; P J Catalano; C Sen; J B Bederson; S Govindaraj Journal: Otolaryngol Head Neck Surg Date: 2000-10 Impact factor: 3.497
Authors: Gerald A Grant; Matthew Jolley; Richard G Ellenbogen; Theodore S Roberts; Joseph R Gruss; John D Loeser Journal: J Neurosurg Date: 2004-02 Impact factor: 5.115
Authors: Thomas Beez; Christopher Munoz-Bendix; Sebastian Alexander Ahmadi; Hans-Jakob Steiger; Kerim Beseoglu Journal: Childs Nerv Syst Date: 2019-07-20 Impact factor: 1.475
Authors: David S Hersh; Hanna J Anderson; Graeme F Woodworth; Jonathan E Martin; Yusuf M Khan Journal: Oper Neurosurg (Hagerstown) Date: 2021-04-15 Impact factor: 2.703
Authors: Thomas Beez; Martin U Schuhmann; Paolo Frassanito; Federico Di Rocco; Ulrich W Thomale; Hans Christoph Bock Journal: Childs Nerv Syst Date: 2022-05-09 Impact factor: 1.532
Authors: Tommi K Korhonen; Maria Suo-Palosaari; Willy Serlo; Maija J Lahtinen; Sami Tetri; Niina Salokorpi Journal: Childs Nerv Syst Date: 2022-06-24 Impact factor: 1.532