Journal article
Patient-specific polymethylmethacrylate prostheses for secondary reconstruction of large calvarial defects: A retrospective feasibility study of a new intraoperative moulding device for cranioplasty.
- Moser M Department of Neurosurgery (Head: A. Weyerbrock), Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland. Electronic address: moser.manuel@gmx.at.
- Schmid R Department of Neurosurgery (Head: A. Weyerbrock), Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland.
- Schindel R Department of Neurosurgery (Head: A. Weyerbrock), Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland.
- Hildebrandt G Department of Neurosurgery (Head: A. Weyerbrock), Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007 St. Gallen, Switzerland.
- 2016-12-25
Published in:
- Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. - 2017
CAD/CAM
CranioTool™
Cranioplasty
PMMA
Patient-specific
Adolescent
Adult
Aged
Bone Plates
Feasibility Studies
Female
Humans
Intraoperative Period
Male
Middle Aged
Polymethyl Methacrylate
Prosthesis Design
Reconstructive Surgical Procedures
Retrospective Studies
Skull
Young Adult
English
PURPOSE
The aim of this study was to review a new template-based technique for intraoperative patient-specific cranioplasty manufacturing (PSCM) with polymethylmethacrylate (PMMA) to cover large calvarial defects.
MATERIAL AND METHODS
A polypropylene foil thermoformed on a three-dimensional reprint of the calvarial defect was used as an intraoperative moulding device for PMMA between August 2012 and December 2015. Surgical and radiological data were retrospectively reviewed, and a patient questionnaire was used to assess functional and cosmetic outcome (numeric rating scale, Odom's criteria).
RESULTS
Seventeen patients (mean age 42.2 ± 14.5 years) received PSCM. Operating time averaged 130 ± 34 min, and the approximate blood loss was 293 ± 185 ml. Volumetric analysis revealed a lower implant volume compared to index bone (mean 66.5 vs. 72 cm3, p = 0.513), the mean difference in thickness being the lowest in the posterior parietal and pterional (0.4-0.7 mm) and the highest in the anterior-superior frontal area (1.8 mm). Cosmetic satisfaction averaged 9 ± 1.5, with 70.6% of patients judging the overall result as excellent or good and 29.4% as satisfactory. Mean follow-up was 19.5 ± 13.3 months, with an overall complication rate of 17.6%, including 11.8% surgical site infections (SSIs) and one implant removal.
CONCLUSIONS
Intraoperative PSCM using PMMA moulded on a thermoformed polypropylene foil leads to satisfactory outcomes. It is a safe technique with complication rates comparable but not superior to those of other alloplastic techniques, but the device has considerable production costs.
The aim of this study was to review a new template-based technique for intraoperative patient-specific cranioplasty manufacturing (PSCM) with polymethylmethacrylate (PMMA) to cover large calvarial defects.
MATERIAL AND METHODS
A polypropylene foil thermoformed on a three-dimensional reprint of the calvarial defect was used as an intraoperative moulding device for PMMA between August 2012 and December 2015. Surgical and radiological data were retrospectively reviewed, and a patient questionnaire was used to assess functional and cosmetic outcome (numeric rating scale, Odom's criteria).
RESULTS
Seventeen patients (mean age 42.2 ± 14.5 years) received PSCM. Operating time averaged 130 ± 34 min, and the approximate blood loss was 293 ± 185 ml. Volumetric analysis revealed a lower implant volume compared to index bone (mean 66.5 vs. 72 cm3, p = 0.513), the mean difference in thickness being the lowest in the posterior parietal and pterional (0.4-0.7 mm) and the highest in the anterior-superior frontal area (1.8 mm). Cosmetic satisfaction averaged 9 ± 1.5, with 70.6% of patients judging the overall result as excellent or good and 29.4% as satisfactory. Mean follow-up was 19.5 ± 13.3 months, with an overall complication rate of 17.6%, including 11.8% surgical site infections (SSIs) and one implant removal.
CONCLUSIONS
Intraoperative PSCM using PMMA moulded on a thermoformed polypropylene foil leads to satisfactory outcomes. It is a safe technique with complication rates comparable but not superior to those of other alloplastic techniques, but the device has considerable production costs.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jcms.2016.11.016
- PMID 28011181
- Persistent URL
- https://sonar.ch/global/documents/186473
Statistics
Document views: 19
File downloads: