HAND-MADE CRANIAL VAULT RECONSTRUCTION: A CASE SERIES ANALYSIS

作者：Lapparelli M; Zollino I; Carnevali G; Trapella G; Lorenzin M A; Cavallo M; Latini F; Brunelli G; Carinci F^*

来源：European Journal of Inflammation, 2011, 9(2): 19-23.

• Skull defect
• polymethylmethacrylate
• hand made
• cranioplasty
• decompressive craniectomy

The authors report the use of hand-made polymethylmethacrylate (PMMA) prosthesis for cranioplasties. None of several materials used to reconstruct skull defects is fully satisfactory, due to biological and physical properties. A retrospective study was performed in order to detect those variables statistically associated to clinical failures. PMMA cranioplasties have been implanted in 23 patients at the Neurosurgery Unit of the Arcispedale S. Anna of the University Hospital of Ferrara, Italy.. The causes of primary operation were 9 (39.1%) cerebral hemorrhages, 9 (39.1%) traumas and 5 (21.7%) tumors, respectively. Hypertension was a co-morbidity factor in 10 (43.5%) patients. Cranial vault reconstruction was performed after a mean period of 4 months and the mean post-operative follow up was 23 months. The variables analyzed were causes of craniotomy (hemorrhages, traumas, tumors and infections), co-morbidity factor (i.e. hypertension), sites (2 frontal, 4 fronto-temporal, 10 fronto-temporo-parietal, 4 occipito-parietal, 1 temporo-parietal and 2 temporo-occipito-parietal) and dimension of the defect (maximum diameter smaller than 9 cm, 9 <= x < 12 cm, equal or greater than 12 cm). Each patient obtained an excellent aesthetic result. There was no reabsorption, rejections or spontaneous fractures related to the cranial vault reconstruction in the follow-up period. In two cases the reconstruction was removed: one brain tumor recurrence and one subdural hemorrhage. No variables had an impact on clinical outcome and thus was demonstrated that dimension is not a limiting factor in hand-made cranial reconstruction. A PMMA hand-made prosthesis is a valid and safe technique both aesthetically and in terms of absence of infections / rejections.

• 出版日期2011-8